达芬奇Xi-vNOTES与术锐SP-vNOTES在子宫切除术中的比较研究

doi:10.3877/cma.j.issn.1674-6899.2026.03.006

目的

比较达芬奇Xi-vNOTES与国产术锐SP-vNOTES在子宫切除术中的临床效果。

方法

回顾性分析2024年10月至2026年2月于南京医科大学第二附属医院行子宫切除术的141例患者，其中达芬奇组87例，术锐组54例。比较两组基线资料、手术指标、围手术期并发症及术后恢复情况。

结果

术锐组装机时间显著短于达芬奇组(3.2±0.8 min vs. 8.1±1.5 min，P<0.001)；两组在手术时间、术中出血量、术后疼痛评分、首次下床时间、首次排尿时间、首次通气时间及并发症发生率等方面差异均无统计学意义(P>0.05)。达芬奇组发生膀胱损伤1例、中转经脐单孔1例；术锐组无上述事件。

结论

国产术锐SP-vNOTES在子宫切除术中具有良好的安全性与有效性，装机效率优于达芬奇Xi-vNOTES，临床效果与达芬奇组相当，是国内微创妇科手术的可行替代方案。

关键词: 子宫切除术, 达芬奇Xi-vNOTES, 术锐SP-vNOTES, 微创手术, 围手术期并发症

Objective

To compare the clinical outcomes of da Vinci Xi-vNOTES and domestic Shurui SP-vNOTES in hysterectomy.

Methods

A retrospective analysis was conducted on 141 patients who underwent hysterectomy at the Second Affiliated Hospital of Nanjing Medical University from Oct. 2024 to Feb. 2026. Among them, 87 patients were in the da Vinci group and 54 patients were in the Shurui group. Baseline data, surgical indicators, perioperative complications, and postoperative recovery were compared between the two groups.

Results

The setup time in the Shurui group was significantly shorter than that in the da Vinci group (3.2±0.8 min vs. 8.1±1.5 min, P<0.001). There were no statistically significant differences between the two groups in operative time, intraoperative bleeding volume, postoperative pain score, time to first ambulation, time to first urination, time to first flatus, and complication rate (P>0.05). In the da Vinci group, there was one case of bladder injury and one case of transumbilical single-port surgery; no such events occurred in the Shurui group.

Conclusion

The domestic Shurui SP-vNOTES demonstrates good safety and efficacy in hysterectomy, with superior setup efficiency compared to da Vinci Xi-vNOTES. Its clinical outcomes are comparable to those of the da Vinci group, making it a feasible alternative for minimally invasive gynecological surgery in China.

Key words: Hysterectomy, Da Vinci Xi-vNOTES, Shurui SP-vNOTES, Minimally invasive surgery, Perioperative complications

图1 机器人4P固定法示意图

表1 一般资料比较

指标	达芬奇组(n＝87)	术锐组(n＝54)	P值
年龄(岁)	52.3±7.8	52.1±8.2	0.782
BMI (kg/m²)	24.6±3.4	24.4±3.6	0.645
孕次	3.1±1.4	2.9±1.6	0.523
产次	1.6±0.7	1.4±0.9	0.391
分娩方式[例(%)]
顺产	61(70.1)	38(70.4)	0.912
剖宫产	26(29.9)	16(29.6)
腹部手术史[例(%)]	39(44.8)	24(44.4)	0.876
经阴道手术史[例(%)]	4(4.6)	3(5.6)	0.734
子宫体积(cm³)	360±260	340±240	0.523

表1 一般资料比较

指标	达芬奇组(n＝87)	术锐组(n＝54)	P值
年龄(岁)	52.3±7.8	52.1±8.2	0.782
BMI (kg/m²)	24.6±3.4	24.4±3.6	0.645
孕次	3.1±1.4	2.9±1.6	0.523
产次	1.6±0.7	1.4±0.9	0.391
分娩方式[例(%)]
顺产	61(70.1)	38(70.4)	0.912
剖宫产	26(29.9)	16(29.6)
腹部手术史[例(%)]	39(44.8)	24(44.4)	0.876
经阴道手术史[例(%)]	4(4.6)	3(5.6)	0.734
子宫体积(cm³)	360±260	340±240	0.523

表2 手术相关指标

指标	达芬奇组(n＝87)	术锐组(n＝54)	P值
装机时间(min)	8.1±1.5	3.2±0.8	<0.001
操作时间(min)	108±16	112±18	0.234
失血量(ml)	95±75	105±85	0.489
术中粘连[例(%)]	26(29.9)	16(29.6)	0.912
中转经脐[例(%)]	1(1.1)	0(0)	－
术后24 h疼痛评分(分)	2.9±1.3	2.7±1.1	0.328
术后1周疼痛评分(分)	1.3±0.9	1.2±0.7	0.457
首次下床时间(h)	11.8±3.9	12.2±4.1	0.603
首次小便时间(h)	7.9±1.9	8.1±2.1	0.528
首次大便时间(d)	2.4±0.9	2.6±1.1	0.374

表2 手术相关指标

指标	达芬奇组(n＝87)	术锐组(n＝54)	P值
装机时间(min)	8.1±1.5	3.2±0.8	<0.001
操作时间(min)	108±16	112±18	0.234
失血量(ml)	95±75	105±85	0.489
术中粘连[例(%)]	26(29.9)	16(29.6)	0.912
中转经脐[例(%)]	1(1.1)	0(0)	－
术后24 h疼痛评分(分)	2.9±1.3	2.7±1.1	0.328
术后1周疼痛评分(分)	1.3±0.9	1.2±0.7	0.457
首次下床时间(h)	11.8±3.9	12.2±4.1	0.603
首次小便时间(h)	7.9±1.9	8.1±2.1	0.528
首次大便时间(d)	2.4±0.9	2.6±1.1	0.374

表3 术后并发症

并发症	达芬奇组(n＝87)	术锐组(n＝54)	P值
输尿管损伤	0(0%)	0(0%)	－
膀胱损伤	1(1.1%)	0(0%)	0.617
尿潴留	4(4.6%)	3(5.6%)	0.832
延迟出血	1(1.1%)	0(0%)	0.617
二次手术	0(0%)	0(0%)	－
感染	2(2.3%)	1(1.9%)	0.891
盆腔血肿	1(1.1%)	0(0%)	0.617

表3 术后并发症

并发症	达芬奇组(n＝87)	术锐组(n＝54)	P值
输尿管损伤	0(0%)	0(0%)	－
膀胱损伤	1(1.1%)	0(0%)	0.617
尿潴留	4(4.6%)	3(5.6%)	0.832
延迟出血	1(1.1%)	0(0%)	0.617
二次手术	0(0%)	0(0%)	－
感染	2(2.3%)	1(1.9%)	0.891
盆腔血肿	1(1.1%)	0(0%)	0.617

图2 国产SR-ENS-600单孔腹腔镜手术机器人系统对偶连续体机构示意图

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Comparative study of da Vinci Xi-vNOTES and Shurui SP-vNOTES in hysterectomy

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Comparative study of da Vinci Xi-vNOTES and Shurui SP-vNOTES in hysterectomy