機器人手術於泌尿道重建手術的應用
何肇晏1、黃一勝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、林宜佳1,2
1.新光吳火獅紀念醫院外科部泌尿科
2.輔仁大學
Robotic surgery in Urinary Tract Reconstruction
Chao-Yen Ho1, Thomas I.S. Hwang1,2, Te-Fu Tsai1,2, Chung-Hsin Yeh1,2, Guang-Dar Juang1,2, Yi-Hong Cheng1, Kuang-Yu Chuo1,2, Hung-En Chen1, Yi-Chia Lin1,2
1.Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital, Taipei, Taiwan
2.Fu-Jen Catholic university, New Taipei, Taiwan
Purpose: We investigate the 21 cases of the robot-assisted laparoscpoic urinary tract reconstructive surgery in Shin Kong WHS Memorial Hospital
Materials and Methods: From June 2014 to March 2019, the totsl twenty-one patients underwent robot-assisted laparoscpoic urinary tract reconstructive surgery in Shin Kong WHS Memorial Hospital were enrolled. These procedures include robotic pyeloplasty, robotic ureteroureterostomy, and robotic ureteral reimplantation.
Results: The most robotic ureteral reconstruction surgery was robotic pyeloplasty, which included 13 patients. The following procedures were robotic ureteroureterostomy (6 cases), and robotic ureteral reimplantation (2 cases). Operative time, estimated blood loss, and the complications were recorded and showed feasible outcome without major complication.
Conclusions: Ureteral reconstructive surgery by traditional laparoscopic approach is not easy. Robotic approach have provided good patient safety and postoperative outcomes. In SKH experience, robotic ureteral reconstruction has shown benefit from use of the robot with the fine tissue manipulation, delicate anastomosis, and minimal blood loss. The robot assisted procedures are feasible in experienced hands and are an option to counsel patients about when discussing surgical avenues for ureteral reconstruction.