[用于自体乳房重建的机器人辅助显微外科手术--机器人乳房重建]。

IF 0.4 4区 医学 Q4 SURGERY Handchirurgie Mikrochirurgie Plastische Chirurgie Pub Date : 2024-04-01 Epub Date: 2024-04-26 DOI:10.1055/a-2241-5737
Kai J Wessel, Charalampos Varnava, Philipp Wiebringhaus, Mirkka Hiort, Tobias Hirsch, Maximilian Kückelhaus
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引用次数: 0

摘要

背景:随着满足开放式显微外科特殊需求的新型手术机器人和手术显微镜的推出,机器人辅助显微外科的概念正日益流行。虽然初步的临床前研究表明,机器人辅助显微外科手术的学习曲线陡峭、人体工程学设计良好、精确度提高(尽管手术时间增加),但有关新系统临床应用的数据仍然有限。本研究介绍了我们首次使用机器人辅助自体乳房重建的临床经验,并概述了这种方法的机遇和局限性:我们的回顾性数据分析包括了2022年7月至2023年8月期间接受单侧机器人辅助自体乳房重建术的28名患者。我们采用了Symani手术系统和RoboticScope的联合方法。对患者特征、手术数据和并发症进行了描述性评估:患者平均年龄为 54.3±11.1 岁,平均体重指数为 26.5±3.5 kg/m2。26例患者接受了DIEP皮瓣,2例患者接受了PAP皮瓣,22例患者的皮瓣与乳内动脉相连,5例患者的皮瓣与乳内动脉穿孔相连,1例患者的皮瓣与胸背动脉分支相连。平均切口-缝合时间为 267±89 分钟,平均缺血时间为 86±20 分钟,动脉吻合时间为 29±12 分钟。有两例患者在术中立即进行了吻合口修补,但没有发生皮瓣脱落:本研究结果表明,使用Symani和RoboticScope组合进行机器人辅助自体乳房重建是安全可行的。今后,应特别关注皮瓣采集和连接血管准备的微创技术。
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[Robot-assisted Microsurgery for Autologous Breast Reconstruction - Robotic Breast Reconstruction].

Background: With the introduction of novel surgical robots and surgical microscopes for the special needs of open microsurgery, the concept of robotic-assisted microsurgery is gaining popularity. While initial preclinical studies indicate a steep learning curve, favourable ergonomics and improved precision, albeit with an increased operating time, data on the clinical application of the new systems is still limited. This study describes our first clinical experience with robotic-assisted autologous breast reconstruction and outlines the opportunities and limitations of the approach.

Patients and methods: Our retrospective data analysis included a total of 28 patients who underwent unilateral robotic-assisted autologous breast reconstruction between July 2022 and August 2023. We applied a combined approach using the Symani Surgical System together with the RoboticScope. Descriptive evaluation of patient characteristics, surgical data and complications was performed.

Results: Average patient age was 54.3±11.1 years and average BMI was 26.5±3.5 kg/m2. Twenty-six patients received a DIEP flap and 2 patients received a PAP flap, the flaps being connected to the internal mammary artery in 22 cases, to a perforator of the internal mammary artery in 5 cases, and to a branch of the thoracodorsal artery in one case. The average incision-suture time was 267±89 min, with an average ischaemia time of 86±20 min and duration of the arterial anastomosis of 29±12 min. In two cases, immediate intraoperative anastomosis revision was performed, but no flap loss occurred.

Conclusion: The results of this study demonstrate the safe feasibility of robot-assisted autologous breast reconstruction using a combination of Symani and RoboticScope. In the future, special attention should be paid to minimally invasive techniques of flap harvest and connecting vessel preparation.

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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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