Li Shuai,Tang Shaotao,Cao Guoqing,et al.Preliminary experience of thoracoscopic pulmonary lobectomy using da Vinci robotic-system in children[J].Journal of Clinical Pediatric Surgery,2020,19(07):619-621,647.[doi:10.3969/j.issn.1671-6353.2020.07.011]
da Vinci机器人辅助胸腔镜下小儿肺叶切除术的初步经验
- Title:
- Preliminary experience of thoracoscopic pulmonary lobectomy using da Vinci robotic-system in children
- Keywords:
- Pneumonectomy; Robotics; Thoracoscopy; Child
- 分类号:
- R616;R729
- 摘要:
- 目的 介绍da Vinci机器人辅助胸腔镜下小儿肺叶切除术的初步经验。方法 2018—2019年华中科技大学同济医学院附属协和医院小儿外科实施了2例da Vinci机器人辅助胸腔镜小儿肺叶切除术，患儿年龄分别为4岁和10岁，体重分别为17 kg和30 kg。术后病理诊断：一例为左下肺叶叶内型隔离肺，一例为右下肺叶先天性肺气道畸形。结果 2例均顺利完成手术。机器人连接时间分别为30 min和10 min；机器人操作时间分别为120 min和90 min；术中出血量分别为20 mL和50 mL；术后拔除胸管时间均为5 d，术后住院时间均为7 d。随访时间分别为12个月和8个月，无气胸、血胸，支气管胸膜瘘及肺不张等并发症。结论 da Vinci机器人辅助胸腔镜进行小儿肺叶切除术安全可行。三维显像系统、灵活的机器人器械及过滤抖动功能更加有利于肺动、静脉及支气管游离，但缺乏触觉反馈易使术中牵拉肺致出血。
- Abstract:
- Objective To summarize the preliminary experience of using da Vinci robotic-assisted thoracoscopic pulmonary lobectomy in children using da Vinci system.Methods From 2018 to 2019,clinical data were retrospectively reviewed for 2 children undergoing robotic-assisted thoracoscopic pulmonary lobectomy.The operative age was 4 and 10 years and the body weight 17 and 30 kg respectively.And the pathologic diagnosis was intralobar pulmonary sequestration and congenital pulmonary airway malformation respectively.Results Both cases underwent robotic-assisted thoracoscopic pulmonary lobectomy successfully.The robotic docking time was 30 and 15 min,the console operating time 120 and 90 min and the volume of intraoperative blood loss 20 and 50 ml respectively.The drainage tube was removed at Day 5 post-operation and discharge occurred at Day 7 post-operation.No instance of pneumothorax,hemothorax,bronchopleural fistula or atelectasis occurred during a follow-up period of 12 and 8 month.Conclusion Robotic-assisted thoracoscopic pulmonary lobectomy is both safe and feasible in children with a body weight of over 15 kg.And 3-D visualization,articulating robotic instruments and tremor filtration facilitate the dissections of pulmonary vein,artery and bronchus.However,retraction of lung without tactile feedback may cause more blood loss.
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备注/Memo
收稿日期:2019-12-14。
通讯作者:汤绍涛,Email:tshaotao83@126.com