程序化达芬奇机器人“3+2”模式“七步法”远端胃癌根治术

黄显斌 狐鸣 蔡辉 詹渭鹏 杨婧 马云涛

黄显斌, 狐鸣, 蔡辉, 詹渭鹏, 杨婧, 马云涛. 程序化达芬奇机器人“3+2”模式“七步法”远端胃癌根治术[J]. 中国肿瘤临床, 2022, 49(3): 124-128. doi: 10.12354/j.issn.1000-8179.2022.20210850
引用本文: 黄显斌, 狐鸣, 蔡辉, 詹渭鹏, 杨婧, 马云涛. 程序化达芬奇机器人“3+2”模式“七步法”远端胃癌根治术[J]. 中国肿瘤临床, 2022, 49(3): 124-128. doi: 10.12354/j.issn.1000-8179.2022.20210850
Xianbin Huang, Ming Hu, Hui Cai, Weipeng Zhan, Jing Yang, Yuntao Ma. Programmed “seven-step method” in distal radical gastrectomy with Da Vinci robot “3+2” mode[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(3): 124-128. doi: 10.12354/j.issn.1000-8179.2022.20210850
Citation: Xianbin Huang, Ming Hu, Hui Cai, Weipeng Zhan, Jing Yang, Yuntao Ma. Programmed “seven-step method” in distal radical gastrectomy with Da Vinci robot “3+2” mode[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(3): 124-128. doi: 10.12354/j.issn.1000-8179.2022.20210850

程序化达芬奇机器人“3+2”模式“七步法”远端胃癌根治术

doi: 10.12354/j.issn.1000-8179.2022.20210850
基金项目: 本文课题受甘肃省青年科技基金计划项目(编号:21JR7RA641)资助
详细信息
    作者简介:

    黄显斌:研究方向为消化道肿瘤的微创及机器人治疗

    通讯作者:

    马云涛 3565515665@qq.com

Programmed “seven-step method” in distal radical gastrectomy with Da Vinci robot “3+2” mode

Funds: This work was supported by the Natural Science Foundation for Young Scientists of Gansu Province (No. 21JR7RA641)
More Information
  • 摘要:   目的  介绍程序化达芬奇机器人“3+2”模式远端胃癌根治手术清扫“七步法”。  方法  回顾性分析2017年6月至2020年6月于甘肃省人民医院完成全腔镜下达芬奇机器人远端胃癌根治术的患者100例。手术分七步:1)建立戳孔,腹腔探查,悬调肝脏,摆体位,连接机器;2)右侧大弯侧区域及幽门下区域(4d,6);3)幽门上区域,离断十二指肠,清扫肝十二指肠韧带(5,12a);4)胰腺前方区域(7,8a,8p,9,11p);5)小弯侧区域(1,3);6)左侧胃大弯区域(4sb);7)离断胃标本,近端胃和空肠吻合。  结果  全部患者无中转开腹,术中无输血。手术时间 (175.0±16) min,出血量(99±36.4)mL,淋巴结清扫数目(30.3±2.5)枚,机器人相关费用(22 794±3 660)元。并发症发生5例,其中肠梗阻2例,腹腔内出血1例、伤口感染1例以及胃排空延迟1例,均采用保守方法治愈。未出现吻合口狭窄及吻合口瘘。  结论  本程序化方法安全可行,重复性好,手术时间相对较短,费用相对较低。该程序化方法有利于新开展机器人手术的机构培养手术团队、缩短学习曲线、降低手术难度,从而更好地服务于临床教学工作。

     

  • 图  1  手术布局示意图及助手站位

    A:手术布局;B:术中第一、二号助手站位

    图  2  “七步法”的要点与难点

    A:悬吊肝脏;B:处理幽门下区域;C:清扫肝十二指肠韧带(12a、12p)淋巴结;D:清扫肝动脉前后(8a、8p)淋巴结

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出版历程
  • 收稿日期:  2021-05-28
  • 录用日期:  2022-01-14
  • 网络出版日期:  2022-03-03

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