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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2024, Vol. 17 ›› Issue (04) : 234 -238. doi: 10.3877/cma.j.issn.1674-6899.2024.04.008

论著

国产单孔手术机器人辅助vNOTES治疗妇科良性疾病
刘洋1, 方芳1, 李莹1, 李青1, 陆倩1, 魏善闯1, XIAOMING GUAN2, 张春花3,†()   
  1. 1. 223002　江苏，淮安市妇幼保健院妇科
    2. 77030　USA,　美国贝勒医学院附属德州儿童医院
    3. 223002　江苏，淮安市妇幼保健院妇科；999078　澳门，澳门科技大学
  • 收稿日期:2024-07-17 出版日期:2024-08-30
  • 通信作者: 张春花
  • 基金资助:
    江苏省妇幼健康科研项目(F202141)

Domestic robotic-assisted single-port transvaginal NOTES (RSP-vNOTES) for the treatment of benign gynecological diseases

Yang Liu1, Fang Fang1, Ying Li1, Qing Li1, Qian Lu1, Shanchuang Wei1, XIAOMING GUAN2, Chunhua Zhang3,†()   

  1. 1. Department of Gynecology, Huai′an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University, Jiangsu 223002, China
    2. Baylor College of Medicine, Minimally Invasive Gynecology Surgery, Houston Texas 77030, USA
    3. Department of Gynecology, Huai′an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University, Jiangsu 223002, China; Macau University of science and technology, Macau 999078, China
  • Received:2024-07-17 Published:2024-08-30
  • Corresponding author: Chunhua Zhang
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引用本文：

刘洋, 方芳, 李莹, 李青, 陆倩, 魏善闯, XIAOMING GUAN, 张春花. 国产单孔手术机器人辅助vNOTES治疗妇科良性疾病[J]. 中华腔镜外科杂志(电子版), 2024, 17(04): 234-238.

Yang Liu, Fang Fang, Ying Li, Qing Li, Qian Lu, Shanchuang Wei, XIAOMING GUAN, Chunhua Zhang. Domestic robotic-assisted single-port transvaginal NOTES (RSP-vNOTES) for the treatment of benign gynecological diseases[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(04): 234-238.

目的

探讨国产单孔手术机器人辅助vNOTES(robotic-assisted single-port transvaginal natural orifice transluminal endoscopic surgery，RSP-vNOTES)在妇科良性疾病中的临床应用可行性和安全性。

方法

回顾性分析2024年1月至2024年6月淮安市妇幼保健院利用国产RSP-vNOTES治疗的20例患者的临床资料，观察机器人系统装机时间与手术时长、术中出血量、术中补液量、术中尿量、术后24 h疼痛情况、术后首次排气时间、术后首次排便时间、手术并发症发生率、住院时间。

结果

机器人系统平均装机时间(5.10±3.11)min。20例患者均顺利完成手术，术后均未发生并发症。平均手术时长(179.43±53.97)min、平均术中出血量(123.81±41.36)ml、平均术中补液量(1490.15±393.28)ml；平均术后24 h视觉模拟评分法(visual analogue scale，VAS)(2.52±1.54)分；平均术后首次排气时间(2.14±0.57)d、平均术后首次排便时间(2.95±0.59)d；平均住院时间(7.94±3.36)d。

结论

国产单孔机器人SP1000装机便捷，操作便利，辅助vNOTES治疗妇科良性疾病具有可行性和安全性。

关键词: 国产单孔手术机器人, vNOTES, 妇科, 良性疾病
Objective

To explore the feasibility and safety of robotic-assisted single-port transvaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) for benign gynecological diseases.

Methods

In this study, we retrospectively analyzed data from 20 patients who underwent RSP-vNOTES procedures assisted by the SP1000 robot, manufactured in China, at Huai′an Maternal and Child Health Hospital between Jan. 2024 and Jun. 2024. The analysis included metrics such as installation and operation times, blood loss, intraoperative fluid volume, intraoperative urine volume, postoperative 24 h pain, postoperative first exhaust time, postoperative first defecation time, incidence of surgical complications, and hospitalization time were observed.

Results

The average installation time of the robot system was (5.10±3.11) min. All 20 patients successfully completed the operation, and no complications occurred after operation. The average operation time was (179.43±53.97) min, the average blood loss was (123.81±41.36) ml, and the average intraoperative fluid volume was (1490.15±393.28) ml. The mean visual analogue scale(VAS) at 24 hours after operation was (2.52±1.54). The average first exhaust time after operation was (2.14±0.57) days, and the average first defecation time after operation was (2.95±0.59) days. The average length of hospital stay was (7.94±3.36) days.

Conclusion

The domestic SP surgical robot is convenient to install and operate, and it is feasible and safe to assist vNOTES in the treatment of benign gynecological diseases.

Key words: Single-port surgical robot, vNOTES, Gynecology, Benign diseases
表1 20例患者诊断及手术方式
病例序号 诊断 手术方式
1 子宫内膜非典型增生 全子宫＋双侧输卵管切除术
2 子宫肌壁间平滑肌瘤 全子宫＋双侧输卵管-卵巢切除＋盆腔粘连松解术
3 左侧卵巢成人型粒层细胞瘤 左侧卵巢切除术＋盆腔粘连松解术
4 子宫粘膜下平滑肌瘤 全子宫＋双侧输卵管切除
5 子宫平滑肌瘤 全子宫＋双侧输卵管切除术
6 子宫腺肌症 全子宫＋双侧输卵管切除＋盆腔粘连松解术
7 右侧卵巢成熟型囊性畸胎瘤 右侧卵巢囊肿剥除术
8 子宫多发肌壁间平滑肌瘤 全子宫＋双侧输卵管切除＋左侧卵巢囊肿剥除术
9 右侧卵巢成熟型囊性畸胎瘤 右侧卵巢病损剥除术
10 子宫脱垂Ⅲ度/阴道前壁膨出Ⅲ度 阴道骶骨固定术(Y型网片置入)＋全子宫切除＋双附件切除
11 阴道前壁脱垂Ⅲ度/子宫脱垂Ⅱ度 全子宫切除＋双附件切除＋高位骶韧带悬吊＋改良前盆底重建＋会阴体重建术
12 子宫脱垂Ⅲ度，阴道前壁膨出Ⅱ度 全子宫＋右附件切除＋改良前盆地重建＋高位骶韧带悬吊＋阴道后壁修补＋会阴体重建术
13 子宫腺肌症 全子宫＋双侧附件切除＋盆腔粘连松解术
14 子宫内膜增生 全子宫＋双侧输卵管切除＋肠粘连松解术
15 子宫腺肌瘤 全子宫＋双侧输卵管切除＋盆腔粘连松解术
16 子宫肌瘤 全子宫＋双侧输卵管切除术
17 宫颈高级别鳞状上皮内病变 全子宫＋双侧输卵管切除术
18 子宫腺肌病 全子宫＋双侧输卵管切除术
19 宫颈高级别鳞状上皮内病变 全子宫＋双侧附件切除术
20 子宫平滑肌瘤 全子宫＋双侧输卵管切除术＋右侧卵巢囊肿剥除
图1 装机时间变化趋势
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