使用單孔加一額外小洞即可施行機械手臂攝護腺根除除手術
李經家 12, 柯宏龍 1, 古曉菁1, 楊凱富 1, 羅英襄1, 李政學1, 呂妍嫚 1, 錢祖明1, 溫聖辰 1 , 黃俊農 1, 周以和1 , 吳文正 1 2
1高雄醫學大學附設醫院 泌尿科
2 高雄市立大同醫院 泌尿科
LESS with additional one port to performed robot-assisted radical prostatectomy
Ching-Chia Li 12, Hung-Lung Ke 1, Shiao Jin Guu 1 , Kai-Fu Yang 1, Ing-Shiang Lo 1 , Cheng-Hsueh Lee 1, Yen-Man Lu 1 ,Tsu-Ming Chien 1 , Sheng-Chen Wen 1 , Chun-Nung Huang 1,Yii-Her Chou1 , Wen-Jeng Wu 1 2
1 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
Abstract
Background Laparoendoscopic single site(LESS) surgery is a technically demanding procedure. We present our experience of robot-assisted radical prostatectomy via a 3~5 cm umbilical port and one additional 8 mm port ( LESS plus one model).
Methods We performed LESS plus one model on 13 patients with localized prostate cancer from May 2016 to Mar. 2017. Surgeries were performed through extraperitoneal route. da Vinci® Single-Site® port was placed in the 3~5 cm unbilical wound enables surgeons to operate through a small incision to perform virtually scarless surgery. A additional small port was created on the right abdominal wall near the anterior axillary.
Results Mean patient age was 66.1 years old (range 56-73). The mean time of extraperitoneal route creation was 42.7 minutes (23∼95 ), mean total operation time was 285.6 minutes (210∼375), mean estimated blood loss was 573.2 mL (180∼1600), mean unbilical incision length was 3.5cm (2.8∼5.4 ). mean time to oral intake was 10.3 hours (8~18) and the mean duration of hospitalization was 9.1 days (9~10).Surgical margin positive rate was 23.1% (3 cases). A patient with low abdominal skin ecchymosis post opertaively.
Conclusion : da Vinci® Single-Site® with one additional small port ( LESS plus one model) is a feasible surgical method for most patients with localized porstate cancer.