腹膜外機械手臂輔助前列腺根除手術
黃建榮1,2 , 薛又仁1,2, 陳修聖1,2, 賴昱維1, 邱文祥1,2
1臺北市立聯合醫院仁愛院區, 2國立陽明大學醫學系
Extraperitoneal robot-assisted radical prostatectomy
Taipei city hospital experience
Andy Huang1,2 , Thomas Y. Hsueh1,2, Saint S. Chen1,2, Yu-Wei Lai1, Allen W. Chiu1,2
1Taipei City Hospital, Renai branch, 2National Yang Ming University, School of Medicine
Purpose
We described and assessed our experienced of extraperitoneal laparoscopic radical prostatectomy performed using the da Vinci (Intuitive Surgical, Mountain View, California) robotic system.
Materials and Methods
From 2014 to 2015, 24 consecutive patients with clinically localized prostate cancer underwent extraperitoneal, robotic assisted laparoscopic radical prostatectomy. After development of the extraperitoneal space with conventional laparoscopic instrument, the surgeon performed robot assisted extraperitoneal laparoscopic radical prostatectomy from the console. The assistant used conventional laparoscopic instruments only with suction-irrigation and laparoscopic allis to facilitate prostatectomy. Perioperative data and pathological results were recorded.
Results
No difficulties were noted when developing the extraperitoneal space. We use balloon dilator to create extraperitoneal space ; confirm and insert trocars with conventional laparoscope. The trocar site is the same with conventional laparoscopic setup. Mean operative time was 174 minutes. Mean catheterization time were 11 days. No major postoperative complications or open conversions were observed..
Conclusions
The extraperitoneal approach was feasible with the da Vinci robotic system.
The procedure offers the advantages of improved dexterity and visualization of the robot, while avoiding the abdominal cavity and potential associated morbidity. Da Vinci robotic extraperitoneal approach for radical prostatectomy simulates the standard open retropubic technique seem will be likely to gain popularity.