Prevention and treatment of intraoperative complications in gynecological robotic surgery

doi:10.3877/cma.j.issn.1674-6899.2023.05.007

Abstract

Abstract:

Objective

To analyze the occurrence of intraoperative complications in the Center for Minimally Invasive Gynecologic Surgery at the First Affiliated Hospital of Zhengzhou University, and to summarize the causes and preventive and curative treatment in order to improve the safety of surgery.

Methods

The medical records of patients admitted to our center for robotic gynecologic surgery from Oct. 2014 to Jun. 2022 were collected for retrospective analysis of intraoperative complications.

Results

A total of 2 000 cases of robotic surgery were analyzed, and 49 cases of intraoperative complications occurred, including 18 cases of vascular injuries, 18 cases of ureteral injuries, 4 cases of bladder injuries, 3 cases of intestinal injuries, 3 cases of occlusive nerve injuries, and 3 cases of subcutaneous emphysema.

Conclusion

The application of robotic surgery in gynecology is safe and feasible, and the incidence of intraoperative complications varies depending on the type of surgery. Attention to complications and being familiar with their associated factors, clinical manifestations, diagnosis and prevention is essential to reduce and avoid complications.

Key words: Robotic surgical system, Intraoperative complication, Robotic gynecologic surgery

Yafen Liu, Zhao Zhao, Nannan He, Yue Li, Penglin Xu, Mei Ji. Prevention and treatment of intraoperative complications in gynecological robotic surgery[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2023, 16(05): 288-292.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2023.05.007

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2023/V16/I05/288

Figures/Tables 4

References 13

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并发症种类	并发症例数(%)	恶性肿瘤1322例(66.1%)				良性疾病678例(33.9%)
并发症种类	并发症例数(%)	宫颈癌	子宫内膜癌	卵巢癌	外阴癌	子宫肌瘤剔除	盆腔脏器脱垂	单纯子宫切除	附件手术
		739(36.95)	412(20.6)	148(12.4)	23(1.15)	134(6.7)	112(5.6)	288(14.4)	144(7.2)
血管损伤	18(0.90)	9(1.21)	4(0.97)	4(2.70)	0	0	0	1(0.35)	0
皮下气肿	3(0.15)	1(0.14)	0	2(1.35)	0	0	0	0	0
肠管损伤	3(0.15)	0	0	2(1.35)	0	0	0	1(0.35)	0
膀胱损伤	4(0.20)	3(0.41)	0	0	0	0	0	1(0.35)	0
输尿管损伤	18(0.90)	14(1.89)	2(0.49)	2(1.35)	0	0	0	0	0
闭孔神经损伤	3(0.15)	0	2(0.49)	1(0.68)	0	0	0	0	0
合计	49(2.45)	27(3.65)	8(1.94)	11(7.43)	0	0	0	3(1.04)	0

并发症种类	并发症例数(%)	恶性肿瘤1322例(66.1%)				良性疾病678例(33.9%)
并发症种类	并发症例数(%)	宫颈癌	子宫内膜癌	卵巢癌	外阴癌	子宫肌瘤剔除	盆腔脏器脱垂	单纯子宫切除	附件手术
		739(36.95)	412(20.6)	148(12.4)	23(1.15)	134(6.7)	112(5.6)	288(14.4)	144(7.2)
血管损伤	18(0.90)	9(1.21)	4(0.97)	4(2.70)	0	0	0	1(0.35)	0
皮下气肿	3(0.15)	1(0.14)	0	2(1.35)	0	0	0	0	0
肠管损伤	3(0.15)	0	0	2(1.35)	0	0	0	1(0.35)	0
膀胱损伤	4(0.20)	3(0.41)	0	0	0	0	0	1(0.35)	0
输尿管损伤	18(0.90)	14(1.89)	2(0.49)	2(1.35)	0	0	0	0	0
闭孔神经损伤	3(0.15)	0	2(0.49)	1(0.68)	0	0	0	0	0
合计	49(2.45)	27(3.65)	8(1.94)	11(7.43)	0	0	0	3(1.04)	0

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