机器人外科学杂志（中英文）2024，Vol.5Issue(3)：420-425,6.DOI:10.12180/j.issn.2096-7721.2024.03.018
机器人辅助阴道骶骨固定术治疗重度盆腔器官脱垂的疗效分析(附手术视频)
Clinical analysis of robot-assisted sacrocolpopexy for severe pelvic organ prolapse(with surgical video)
摘要
Abstract
Objective:To explore the efficacy and safety of robot-assisted sacrocolpopexy in the treatment of severe pelvic organ prolapse.Methods:A total of 54 patients with severe pelvic organ prolapse who received robot-assisted sacrocolpopexy(RASC)in the Department of Gynecology,Affiliated Hospital of Qingdao University from January 2021 to December 2023 were included in the study.Among them,32 patients(59.26%)underwent modified robotic levator ani muscle fascia-sacrocolpopexy for severe posterior vaginal prolapse,22 patients(40.74%)underwent conventional sacrocolpopexy,and 5 patients underwent TVT-O for SUI.The perioperative and operative data of all patients were recorded,and the follow-up data at 1 month,6 months and 12 months after surgery were collected to compare the treatment effect,safety and feasibility of POP.The pelvic floor Dysfunction Questionnaire(PFDI-20)and the Simple Pelvic Floor Dysfunction Impact Questionnaire(PFIQ-7)were used to evaluate the subjective satisfaction after surgery,and the PISQ-12 was used to evaluate the sexual satisfaction.Results:All surgeries were successfully completed,no conversion to laparotomy,no damage to large blood vessels and adjacent organs.The mean intraoperative blood loss was(40.37±19.62)ml,the mean operative time was(186.11±68.91)min,and the mean postoperative hospital stay was(3.63±1.70)d.All 54 patients were followed up at 6 months and 12 months after surgery,and the longest follow-up was 22 months.POP-Q scores after surgery were significantly improved compared with those before surgery,and no patients recurred.The objective and subjective cure rates were 100%.PFDI-20 and PFIQ-7 showed that the quality of life of patients was significantly improved at 6 and 12 months after operation.In 12 months after surgery,40 patients resumed sexual activity,all patients did not report sexual pain and discomfort except one patient with mesh exposure,and there was no significant difference in PISQ-12 scores before and after surgery.Postoperative vaginal stump infection occurred in 2 cases(3.7%)and persistent vaginal stump mesh exposure in 1 case(1.85%),which healed after repair surgery.Conclusion:Robotic surgical system has technical advantages in the treatment of severe POP,especially in patients with severe posterior vaginal prolapse and intestinal hernia.RASC could be one of the promising surgical options for its safe and accurate effect.关键词
机器人辅助手术/盆腔器官脱垂/肠疝/阴道骶骨固定术Key words
Robot-assisted Surgery/Pelvic Organ Prolapse/Intestinal Hernia/Sacrocolpopexy分类
医药卫生引用本文复制引用
王丽杉,左丽,夏玉芳,孙欣,娄艳辉..机器人辅助阴道骶骨固定术治疗重度盆腔器官脱垂的疗效分析(附手术视频)[J].机器人外科学杂志（中英文）,2024,5(3):420-425,6.基金项目
青岛市市南区科技计划项目(2022-2-006-YY) Science and Technology Plan Project of Shinan District of Qingdao City(2022-2-006-YY) （2022-2-006-YY）
