達文西手術於泌尿科領域的應用: 最初九個月的經驗分享
何肇晏1、黃一勝1,2、林宜佳1,2、蔡德甫1,2、葉忠信1,2、莊光達1,2、鄭以弘1、仇光宇1,2、陳宏恩1
1.新光吳火獅紀念醫院外科部泌尿科
2.輔仁大學
Robotic surgery in field of urology: a preliminary experience of nine months
Chao-Yen Ho1, Thomas I.S. Hwang1,2, Yi-Chia Lin1,2, Te-Fu Tsai1,2, Chung-Hsin Yeh1,2, Guang-Dar Juang1,2, Yi-Hong Cheng1, Kuang-Yu Chuo1,2, Hung-En Chen1
1.Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital, Taipei, Taiwan
2.Fu-Jen Catholic university, New Taipei, Taiwan
Purpose:
The robotic surgery was wildly developed in Taiwan in these years. The major advances aided by surgical robots include remote surgery, minimally invasive surgery, better control over surgical instruments and a better view of surgical sites. We report a single institution's preliminary experience with robotic surgery in field of urology and its clinical outcomes.
Materials and Methods:
Preliminary clinical data from June 2014 to February 2015 of robotic surgery in the Shin Kong Wu Ho-Su Memorial Hospital was obtained. The perioperative outcomes and surgeon’s experience is collected.
Results:
From June 2014 to February 2015, fourty-three patients underwent robot assisted laparoscopic procedure in urology department. Seventeen robot assisted laparoscopic prostatectomy(RALP), seven robotic partial nephrectomy(RPN), five robotic nephreureterectomy(RNU), four robotic adrenalectomy, two robotic radical nephrectomy(RRN), two robotic left RNU + cystectomy + hysterectomy, two robotic pyeloplasty, two Robotic retroperitoneal tumor excision, a robotic ureteroureterostomy and a robotic bilateral hernioplasty were performed. The median operative time was 275 minutes and the median estimated blood loss was 300ml. Overall hemotransfusion rate was 14% and complication rate was 11%.
Conclusions:
Robotic surgery is a safe procedure with minimal complications and favorable clinical and functional outcomes. Most of patients have shorter length of hospital stay and less wound pain while compared with our previous experience of open surgery. Better control over surgical instruments and a better 3-D view of surgical sites let the robotic surgeries are well performed by the surgeons used to perform open surgery. Surgical outcome may improve with case numbers.