Versius机器人系统在机器人辅助根治性前列腺切除术中的初步经验:对58例病例的研究。

IF 1.4 Q3 UROLOGY & NEPHROLOGY Central European Journal of Urology Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI:10.5173/ceju.2023.241
Wojciech Polom, Marcin Matuszewski
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引用次数: 0

摘要

简介:该研究介绍了在一个没有机器人手术经验的泌尿外科中心使用Versius机器人系统进行机器人辅助前列腺癌根治术(RARP)的初步结果:对58例前列腺癌根治术进行了回顾性分析,包括患者参数和Versius系统性能:研究涉及 58 名患者(平均年龄 66.9 岁)。术前前列腺特异性抗原(PSA)中位数为9.8纳克/毫升,48%的患者活检结果为ISUP分级≥3级,25.8%的患者核磁共振成像显示前列腺外扩展。中位失血量为 437 毫升,出现并发症(10.3% 为 Clavien-Dindo II 级,4 例为 III 级)。有一次转为开放手术(0.58%)。最终病理结果显示,46.5%的患者患有前列腺外疾病,25.8%的患者边缘呈阳性。手术后,96.5%的患者在6周时检测不到PSA。6周时的尿失禁率为89.7%,12个月时增至91.3%。导管持续时间中位数为 7.9 天,住院时间为 4.5 天。控制台时间平均为 150.9 分钟,中位手术时间为 213 分钟。Versius系统在24.1%的手术中报告了中等优先级警报,其中包括1266次机械臂冲突警报和43次器械交换警报。在控制台或机器人系统未发生故障的情况下,发生了一次床旁设备交换:结论:没有机器人手术经验的泌尿外科中心也能成功引进 Versius 机器人系统。我们的设置和手术室定位是有效、安全和可重复的。我们遇到并解决了手术和技术方面的难题。需要进一步的后续研究来评估该系统的性能。
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Initial experience of the Versius robotic system in robot-assisted radical prostatectomy: a study of 58 cases.

Introduction: The study presents the initial outcomes of robot-assisted radical prostatectomies (RARPs) using the Versius robotic system in a urological centre with no prior robotic surgery experience.

Material and methods: A retrospective analysis of 58 RARPs was conducted, including patients' parameters as well as Versius system performance.

Results: The study involved 58 patients (average age 66.9 years). Median preoperative prostate specific antigen (PSA) was 9.8 ng/ml, with 48% having ISUP grade group ≥ 3 on biopsy and 25.8% showing extraprostatic extension on MRI. Median blood loss was 437 ml, with complications (10.3% Clavien-Dindo grade II and 4 grade III cases). One conversion to open surgery occurred (0.58%). Final pathology revealed 46.5% extraprostatic disease, and 25.8% had positive margins. Post-surgery, 96.5% had undetectable PSA at 6 weeks. Continence rates were 89.7% at 6 weeks, increasing to 91.3% at 12 months. Median catheter duration was 7.9 days, and the hospital stay was 4.5 days. Console time averaged 150.9 minutes, with a median operative time of 213 minutes. The Versius system reported medium priority alarms in 24.1% of operations, including 1266 alarms related to robotic arm clashes and 43 instrument swaps. One bedside unit exchange occurred with no console or robotic system failures.

Conclusions: The Versius robotic system can be successfully introduced in a urological centre without prior robotic surgery experience. Our setup and operating room positioning are effective, safe, and reproducible. We encountered and resolved surgical and technical challenges. Further follow-up studies are needed to assess the system's performance.

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来源期刊
Central European Journal of Urology
Central European Journal of Urology UROLOGY & NEPHROLOGY-
CiteScore
2.30
自引率
8.30%
发文量
48
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