摘要
目的:介绍应用达芬奇外科(Da Vinci S Surgical)系统成功完成10例机器人辅助腹腔镜输尿管非乳头再植术的方法和临床效果。方法:本组输尿管末端狭窄并肾积水患者10例,左侧7例,右侧4例,平均年龄34.9岁,术前B超、IVU及逆行尿路造影等检查诊断为输尿管扩张,程度均为Ⅴ级。所有患者均采用经腹腔人路,手术步骤包括输尿管的分离和离断、双"J"管置入、输尿管膀胱再植等关键步骤。结果:所有手术均获得成功,无中转开放手术及术中并发症,平均手术时间93 min,平均吻合时间33 min,平均术中出血量约30.5 ml;平均术后引流量320 ml,平均术后住院时间8.9天,平均卧床时间3.5天;术后随访3～12个月,肾输尿管积水完全消失9例,明显好转1例(Ⅰ级)。结论:机器人辅助腹腔镜输尿管非乳头再植术是简便可行的手术方法,创伤小,安全可靠,疗效确定。
Objective：To introduce our technique and experience with 10 cases of robotic-assisted laparoscopic reimplantation for tunneling ureteral reimplantation method of non-papillary and clinical results. Methods： This group have 10 patients with distal ureteral stricture underwent robotic-assisted laparoscopic ureteral reimplantation ,7 case in left and 4 cases in right, average age 34.9 years, before surgery B, IVU, and retrograde urography in the diagnosis of ureteral expansion are V grade level. All patients were treated by abdominal approach, operative procedures, including separation and interruption of ureteral double ＂J＂ tube placement, ureteral reimplantation and the key steps. Results： All the operations were accomplished successfully. All patients had no intraoperative complications or need for open conversion. The mean operation time was 93 minutes. The mean anastomosis time was 33 minutes. The mean estimated blood loss was 30.5 ml. The mean postoperative drainage 320 ml. The mean postoperative hospital stay was 8.9 days. The mean bed rest time was 3.5 days. The patients were followed up for 3 to 12 months, 9 patients showed normal drainage without obstruction or reflux and one case singnificantly improved （1 grade）. Conclusions： Robotic-assisted laparoseopic noneverted ureteral reimplantation is technically simpie, reliable, effective, and feasible.
出处
《临床泌尿外科杂志》
北大核心
2010年第6期405-407,418,共4页
Journal of Clinical Urology
