Completely robotic surgical system combined with intraoperative gastroscopy for pylorus-preserving midgastrectomy in gastric body cancer
10.3969/j.issn.1672-2159.2024.04.006
- VernacularTitle:完全机器人手术系统联合术中胃镜行保留幽门的中段胃切除在胃体癌的应用
- Author:
Xiong LUO
1
;
Hong-Liang YAO
Author Information
1. 410011 中南大学湘雅二医院胃肠外科
- Keywords:
Fully robotic pylorus-preserving gastrectomy(FRPPG);
Early gastric cancer(EGC)
- From:
Modern Interventional Diagnosis and Treatment in Gastroenterology
2024;29(4):415-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of a fully robotic surgical system combined with intraoperative gastroscopy for pylorus-sparing midstream gastrectomy in the treatment of midstream gastric carcinoma.Methods A descriptive case series study was used to retrospectively collect and analyze the clinical data of 7 cases of pylorus-preserving radical mesogastric body cancer resections performed by the Department of Gastrointestinal Surgery at the Second Hospital of Xiangya,Central South University,between May 2023 and September 2023 with the combination of a fully robotic surgical system and an intraoperative gastroscope in a two-scope combination.Intraoperative gastroscopic titanium clip was used to localize the lesion location,Trocar was placed by 5-hole method,and midgastric resection was performed under the complete robot,and end-to-end manual suture of gastric fundus and gastric body was performed.The operation,perioperative condition and postoperative pathology as well as follow-up were observed.Measurement information is expressed as mean(range)or M(range),and count information is expressed as frequency.Results All 7 patients successfully underwent radical resection of pylorus-preserving mid-segment gastric carcinoma with a complete robotic surgical system combined with intraoperative gastroscopy and double endoscopy,without conversion laparotomy or intraoperative blood transfusion.The average operation time was 182(165～195)min,the average intraoperative blood loss was 45(40～60)ml,the average surgical incorporation length was 3.3(3.0～4.0)cm,the average postoperative exhaust time was 2.4(2.0～3.0)days,the average postoperative first defecation time was 3.0(2.0～4.0)days,the average postoperative intake time was 3.9(3.0～5.0)days,the average postoperative hospital stay was 7.6(7.0～9.0)days,and the average postoperative time to remove the abdominal drainage tube was 4.9(4.0～6.0)d,the average postoperative urinary catheter removal time was 1.3(1.0～2.0)days,the average postoperative first postoperative activity time was 2.3(2.0～3.0)days,and there were no serious operation-related complications during hospitalization.Telephone follow-up patients were followed up for 6 months after surgery,and the postoperative incision healed well in all groups,and there were no postoperative gastric perforation,postoperative anastomotic bleeding,anastomotic leakage,anastomotic stenosis,no gastric paralysis or severe malnutrition,only one patient had mild symptoms of acid reflux,belching and abdominal distension caused by gastric emptying disorders,and none of the other patients had severe postprandial discomfort or symptoms of bile reflux gastritis,and the subjective overall nutritional scores were all in grade A or B,and no patients had tumor recurrence,metastasis or death.Regular bowel movements,satisfactory quality of life.Conclusion The complete robotic surgical system combined with intraoperative gastroscopy for pylorus-preserving mid-segment gastrectomy has unique advantages,good safety and feasibility,and a good short-term prognosis after surgery,which is conducive to improving the postoperative quality of life of patients.
