Selection of surgical approach for patients with reoperation using Da Vinci surgical system
10.3760/cma.j.issn.1673-9752.2010.02.009
- VernacularTitle:达芬奇机器人手术系统再手术入路的选择
- Author:
Junzhou CHEN
;
Ningxin ZHOU
;
Quanda LIU
;
Xiaodong ZHANG
;
Jungui LIU
;
Kai CHEN
;
Tao ZHANG
- Publication Type:Journal Article
- Keywords:
Da Vinci surgical system;
Surgical procedures,minimally invasive;
Liver;
Biliary tract;
Pancreas
- From:
Chinese Journal of Digestive Surgery
2010;9(2):105-108
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experience of operations with Da Vinci surgical system in 27 patients with previous abdominal surgery.Methods The clinical data of 27 patients with previous abdominal surgery who had received reoperation using Da Vinci surgical system at General Hospital of Second Artillery of PLA from January to December 2009 were retrospectively analysed.The distribution of trocars was designed according to the surgical sites and previous surgical incision sites.The operation was divided into 2 steps:firstly,intraabdominal adhesion was dissected and the robotic arms were set up;secondly,the lesions were resected.Experience in trocars placement,surgical approach and management of complications were summarized.Results Six approaches were designed according to previous incision sites.Of all patients,22 were with severe intraabdominal and hepatic hilar band adhesion,and 5 with strip adhesion.One patient who underwent intraabdominal radiotherapy and chemotherapy abandoned robotic surgery because of the failure in trocar placement and pneumoperitoneum establishment.Twenty-six patients had successfully undergone robotic surgery and the success rate was 96%(26/27).Of the 26 patients,1 was complicated with enterorrhexis intraoperatively and received repairment.No postoperative complication was observed.Conclusions Previous abdominal surgery has little influence on robotic surgery with Da Vinci system. Pneumoperitoneum establishment,insertion point of the first trocar and dissection of the intraabdominal adhesions are key points for success of operation.
