摘要
Abstract
Objective To summarize the clinical experience of robotic hepatobiliary and pancreatic surgery in our center.Methods da Vinci surgical system was applied to perform robotic hepatobiliary and pancreatic operations for 124 patients from Mar 2010 to Mar 2013.The intra-and post-operative data including morbidity were analyzed.Results The robotic hepatectomy was performed in 15 cases.One case was converted to open surgery and 1 case laparoscopic surgery.There was no morbidity and no mortality in these cases.The mean operation time,operative bleeding and postoperative stay were (199.6±110.5) min,(703.3±1260.7) mL and (11.0±3.6) days,respectively.Robotic biliary operations were performed in 7 cases,none was converted to open surgery,the morbidity was 14.3％ and no mortality.The results of the 3 operative and postoperative parameters were (212.9±64.2) min,(257.1±127.2) mL and (6.8±2.5) days,respetively.For 102 cases of the roboic pancreatic surgery,1 case in the benign subset was converted to open surgery and the morbidity 50.0％ and no mortality.Two cases in the malignant subset were converted to open suregery,the morbidity is 55.9％ and 1 patient was dead during the perioperative period.The pancreatic operations involves in 5 types.The number of cases in each operative type and the results of the 3 operative and postoperative parameters were as follows:31 cases with pancreaticoduodenectomy and the parameters were (450.4±102.1) min,(506.5±266.5) mL,(34.4±7.8) days; 42 cases with distal pancreatectomy and (161.0±68.7) min,(278.0±331.5) mL,(20.9±10.9) days; 16 cases with medial pancreatectomy and (215.6±45.7) min,(145.6± 118.4) mL,(22.7±8.0) days; 7 cases with Beger operation and (284.2±35.8) min,(321.7±244.2) mL,(26.3±7.7) days; and 6 cases with enucleation and (116.7±37.2) min,(61.7±69.1) mL,(27.8±11.8) days,respectively.Conclusions With da Vinci surgical system,the surgeon can safely and feasibly perform all kinds of hepatobiliary and pancreatic operations promoting the development of minimally invasive surgery.The application of da Vinci surgical system is the effective supplement to traditional laparoscopic surgery especially in complicated hepatobiliary and pancreatic surgery.At the first period of the application of robotic surgery,the patients should be carefully chosen especially for cases with pancreatic operations.关键词
"达芬奇"外科系统/机器人手术/微创外科/肝胆胰外科Key words
da Vinci surgical system/Robotic surgery/Minimally invasive surgery/Hepatobiliary pancreatic surgery分类
医药卫生
