单端口机器人椎体成形术:早期单中心经验。

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY International Braz J Urol Pub Date : 2023-11-01 DOI:10.1590/S1677-5538.IBJU.2023.0406
Francesco Ditonno, Antonio Franco, Celeste Manfredi, Alexander K Chow, Srinivas Vourganti, Edward E Cherullo, Riccardo Autorino
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引用次数: 0

摘要

目的:肾盂输尿管连接部梗阻(UPJO)是肾积水的常见原因,尤其是在年轻患者中。这种情况的治疗模式已经从开放式肾盂成形术转向微创肾盂成形术。在本研究中,我们描述了我们通过脐周切口进行单端口(SP)机器人辅助肾盂成形术(RAP)的初步单中心经验。材料和方法:患者处于60度左侧位,SP系统与位于脐周3cm切口中的接入端口(Intuitive Surgical,加利福尼亚州桑尼维尔,美国)对接。机器人仪器的部署如下:相机在12点钟,双极抓取器在9点钟,剪刀在3点钟,Cadiere在6点钟。在对输尿管和肾盂输尿管连接处(UPJ)进行分离和鉴定后,在该水平处横切输尿管,然后进行溅射。吻合是通过两个半连续的缝合线,在JJ支架上进行的。结果:2021年至2023年间,我们机构共进行了8次SP RAP,中位(四分位间距,IQR)为23年(20.5-36.5)。术中结果显示,中位OT(IQR)210.5分钟(190-240.5),中位估计失血量(EBL)50毫升(22.5-50)。未出现术后并发症,中位(IQR)停留时间(LOS)为31小时(28.5-34)。结论:在本研究中,我们评估了SP RAP的可行性和安全性。观察到的结果和潜在益处,加上SP平台的适应性,对SP系统在肾盂成形术治疗中的应用具有很好的意义。
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Single Port Robotic Pyeloplasty: early single-center experience.

Purpose: Ureteropelvic junction obstruction (UPJO) is a prevalent cause of hydronephrosis, especially in young patients. The treatment paradigm for this condition has shifted from open to minimally invasive pyeloplasty. In the present study we describe our initial single centre experience with single port (SP) robot-assisted pyeloplasty (RAP) via periumbilical incision.

Material and methods: With the patient in a 60-degree left flank position, the SP system is docked with the Access port (Intuitive Surgical, Sunnyvale, CA, US) placed in a periumbilical 3 cm incision. Robotic instruments are deployed as follows: camera at 12 o'clock, bipolar grasper at 9 o'clock, scissors at 3 o'clock and Cadiere at 6 o'clock. After isolation and identification of the ureter and the ureteropelvic junction (UPJ), the ureter is transected at this level and then spatulated. Anastomosis is carried out by two hemicontinuous running sutures, over a JJ stent.

Results: Between 2021 and 2023, a total of 8 SP RAP have been performed at our institution, with a median (interquartile range, IQR) of 23 years (20.5-36.5). Intraoperative outcomes showed a median (IQR) OT of 210.5 minutes (190-240.5) and a median (IQR) estimated blood loss (EBL) of 50 mL (22.5-50). No postoperative complications were encountered, with a median (IQR) length of stay (LOS) of 31 hours (28.5-34).

Conclusion: In the present study we evaluated the feasibility and safety of SP RAP. The observed outcomes and potential benefits, combined with the adaptability of the SP platform, hold promising implications for the application of SP system in pyeloplasty treatment.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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