扶镜机器人在急腹症手术中的研究与应用

    Research and application of robot-assisted laparoscopy in acute abdominal surgery

    • 摘要:
      目的 探讨扶镜机器人在急腹症手术临床应用中的可行性与安全性。
      方法 选取住院急诊行阑尾切除术、胆囊切除术、嵌顿性疝(部分伴有肠梗阻)和消化道穿孔手术的病人临床资料,根据不同的扶镜方式分为机器人辅助扶镜组和人工扶镜组,收集病人性别、年龄、体质量指数(BMI)、手术时间、术中出血、住院时间、参与手术外科医生人数、并发症发病率相关临床资料。
      结果 共纳入病人203例,其中急性阑尾炎90例,急性胆囊炎60例,嵌顿性腹股沟疝23例,消化道穿孔30例。机器人辅助扶镜组和人工扶镜组在年龄、性别、BMI、术中出血、住院时间以及并发症发生率等方面并无差异,但机器人辅助扶镜组的外科医生数明显少于人工组(P<0.01)。
      结论 机器人辅助扶镜在急腹症手术中是安全、可行的,机器人辅助扶镜可以提供更加稳定而准确的手术视野,更有利于主刀医生操作,提高手术效率;同时,机器人辅助扶镜,可以减少一位扶镜助手,减少人力成本的同时,可以让更多的医生投身到其他急诊工作中。

       

      Abstract:
      Objective To explore the feasibility and safety of robot-assisted scope in the clinical application of acute abdominal surgery.
      Methods The clinical data of patients treated with appendectomy, cholecystectomy, incarcerated hernia(some with intestinal obstruction), and gastrointestinal perforation surgeries were selected, and the patients were divided into the robot-assisted laparoscopy group and conventional laparoscopy group.The gender, age, body mass index (BMI), operation time, intraoperative bleeding and length of stay of hospital patients, number of surgeons involved in surgery and incidence of complications were analyzed.
      Results A total of 203 patients were included, including 90 cases of acute appendicitis, 60 cases of acute cholecystitis, 23 cases of incarcerated inguinal hernia and 30 cases of gastrointestinal perforation.There was no statistical significance in the age, gender, BMI, intraoperative bleeding, length of hospital stay and incidence of complications between the robot-assisted laparoscopy group and conventional laparoscopy group.However, the number of surgeons involved in surgery in the robotassisted laparoscopy group was significantly lower than that in conventional group(P < 0.01).
      Conclusions Robot-assisted endoscopy is safe and feasible in acute abdominal surgery.Robot-assisted endoscopy can provide a more stable and accurate surgical field of view, which is more conducive to the operation of the surgeon, and improves surgical efficiency.At the same time, robot-assist laparoscopy can reduce one assistant, reduce labor costs, and allow more doctors to devote themselves to other emergency work.

       

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