分析达芬奇机器人手术系统辅助脾动脉瘤切除重建术的临床疗效。

采用回顾性描述研究型方法，收集2022年5~10月陆军军医大学第一附属医院血管外科收治的2例行第四代达芬奇机器人辅助脾动脉瘤切除血管重建术患者的临床资料，观察术中、术后情况；采用门诊方式进行随访，了解患者脾动脉吻合口和靶器官情况。随访时间截至2022年11月。

2例患者均成功行第四代达芬奇机器人辅助脾动脉瘤切除重建术。患者A手术时间280 min，其中血管吻合时间30 min；患者B手术时间370 min，其中血管吻合时间43 min；脾动脉端端吻合口均吻合良好，松开阻断后无明显漏血。患者A术中出血量40 ml，患者B术中出血量60 ml。术中及术后均无腹腔大出血、感染等并发症。术后住院时间5 d，术后复查上腹部CT提示脾动脉吻合口通畅，脾脏供血良好。

达芬奇机器人手术系统辅助脾动脉瘤切除血管重建安全、可行，近期疗效较好。

To analyze the clinical effect of da Vinci robotic surgical system assisted splenic aneurysm resection and reconstruction.

The clinical data of 2 cases of splenic aneurysm resection and revascularization assisted by the fourth generation da Vinci robot admitted to vascular surgery Department of Army Medical University from May to Oct. 2022 were collected by retrospective descriptive research method, and the intraoperative and postoperative conditions were observed. Follow up was conducted in the outpatient way to understand the splenic artery anastomosis of the patient. The follow-up period was up to Nov. 2022.

Both patients successfully underwent the fourth generation robot-assisted splenic aneurysm resection and reconstruction. The operation time of patient A was 280 minutes, including 30 minutes of vascular anastomosis. The operation time of patient B was 370 minutes, of which the vascular anastomosis time was 43 minutes. The splenic artery anastomosis was good from end to end, and there was no obvious blood seepage after release and occlusion. The intraoperative hemorrhage of patient A was 40 ml and that of patient B was 60 ml. There were no complications such as abdominal hemorrhage and infection during and after operation. Postoperative hospital stay was 5 days, postoperative review of the upper abdominal CT indicated that the splenic artery anastomosis was patency, spleen blood supply was good.

Splenic aneurysm resection and vascular reconstruction assisted by da Vinci robotic surgical system is safe, feasible and effective in the near term.