单孔机器人经剑突下手术治疗前纵隔疾病:试点试验

IF 1.6 Q2 SURGERY
Chuan Cheng, Evangelos Tagkalos, Chong Beng Ng, Ya-Chun Hsu, Yu Ya Huang, Ching Feng Wu, Yin-Kai Chao
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引用次数: 0

摘要

目的:近年来,经剑突下单孔胸腔镜微创纵隔手术越来越受到关注。尽管这种方法具有潜在的优势,但由于需要在狭窄的胸骨后空间进行复杂的手术操作,因此阻碍了这种方法的广泛采用。机器人手术有可能克服胸腔镜技术固有的局限性:这是一项临床试验(NCT05455840),旨在评估在前纵隔疾病患者中使用达芬奇® SP 系统(Intuitive Surgical, Sunnyvale, CA, USA)进行经剑突下单孔手术的可行性和安全性。主要终点包括转换率,次要终点包括围手术期并发症的发生率:2022年8月至2023年4月期间,共有15名患者(7名男性,8名女性;中位年龄=56岁,四分位距[IQR]:49岁至65岁)接受了经胸手术:中位年龄=56岁,四分位数范围[IQR]:49至65岁)接受了经剑突下机器人手术,使用达芬奇SP平台进行最大胸腺切除术(2例)或前纵隔肿块切除术(13例)。所有手术均顺利进行,无需转为开放手术或创建额外的端口。对接时间的中位数为2分钟(IQR:1至4分钟),控制台时间的中位数为152分钟(IQR:95至191分钟)。术后无并发症,患者术后住院时间中位数为 2 天,30 天内无意外再入院:这项研究表明,在前纵隔疾病患者中使用达芬奇SP系统进行经剑突下单孔机器人手术在临床上是可行的,其安全性和短期疗效均可接受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Single-Port Robotic Trans-Subxiphoid Surgery for Anterior Mediastinal Disease: A Pilot Trial.

Objective: In recent years, there has been an increasing focus on minimally invasive mediastinal surgery using a trans-subxiphoid single-port thoracoscopic approach. Despite its potential advantages, the widespread adoption of this method has been hindered by the intricate surgical maneuvers required within the confined retrosternal space. Robotic surgery offers the potential to overcome the limitations inherent in the thoracoscopic technique.

Methods: This was a clinical trial (NCT05455840) to evaluate the feasibility and safety of utilizing the da Vinci® SP system (Intuitive Surgical, Sunnyvale, CA, USA) for trans-subxiphoid single-port surgery in patients with anterior mediastinal disease. The primary endpoints encompassed conversion rates and the secondary endpoints included the occurrence of perioperative complications.

Results: Between August 2022 and April 2023, a total of 15 patients (7 men and 8 women; median age = 56 years, interquartile range [IQR]: 49 to 65 years) underwent trans-subxiphoid robotic surgery using da Vinci SP platform for maximal thymectomy (n = 2) or removal of anterior mediastinal masses (n = 13). All surgical procedures were carried out with success, with no need for conversion to open surgery or the creation of additional ports. The median docking time was 2 min (IQR: 1 to 4 min), while the console time had a median of 152 min (IQR: 95 to 191 min). There were no postoperative complications and patients experienced a median postoperative hospital stay of 2 days with no unplanned 30-day readmission.

Conclusions: This study shows that trans-subxiphoid single-port robotic surgery employing the da Vinci SP system in patients with anterior mediastinal disease is clinically viable with acceptable safety and short-term outcomes.

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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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