使用 Versius 手术平台的机器人辅助前列腺癌根治术:客观批评和最佳手术设置指南。

IF 1.3 Q3 UROLOGY & NEPHROLOGY
Arab Journal of Urology Pub Date : 2024-12-15 eCollection Date: 2025-01-01 DOI:10.1080/20905998.2024.2442267
Mahmoud A Abdelhakim, Mohamed Abdelwahab
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引用次数: 0

摘要

目的:这是一项观察性研究,旨在为Versius机器人系统的最佳设置提供指导,并评估其在机器人辅助根治性前列腺切除术(RARP)中的性能。患者和方法:在2022年7月至2022年12月期间,纳入了所有病理证实的前列腺癌患者进行根治性前列腺切除术。既往腹部手术或不适合气腹的患者被排除在外。前瞻性地收集术前、术中和术后数据。RARP通过5个端口(12 mm)进行;3个用于机械臂,1个用于相机,1个用于助理外科医生。反复调整患者的体位和端口分布以及床边单元的配置、排列和方向,直到达到最佳设置。在每个案例中都确定了技术故障,并在随后的案例中进行了修复。所有患者于术后第一周和第二周到随访诊所进行常规访问,然后每月进行一次,持续三个月。结果:30例患者均未转腹腔镜或开腹手术,均遵守随访方案。由于警报和与武器有关的冲突反复出现,前9个案例需要经常调整设置。此后21例术后无系统报警,平均对接时间、控制台时间、尿道膀胱吻合时间、总手术时间均有所提高。没有与机器人系统使用相关的主要术中并发症的报道。所有参与者术后疗程均顺利通过。住院时间中位数为2(1-2)天,置管时间中位数为7(7-10)天。结论:Versius系统提供了一个有前途的机器人平台,具有灵活的手术设置。所提出的设置为RARP的平稳运行提供了指导,以最小的仪器碰撞避免系统故障。作为第一代手术机器人系统,未来仍需要努力提高其性能并尽量减少其缺点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Robot-assisted radical prostatectomy with the Versius surgical platform: An objective criticism and a guide for an optimal surgical setup.

Objectives: This was an observational study aiming at providing a guide for an optimal setup of the Versius robotic system and evaluating its performance in robot-assisted radical prostatectomy (RARP).

Patients and methods: Between July 2022 and December 2022, all patients with pathologically confirmed prostate cancer candidates for radical prostatectomy were included. Patients who had previous abdominal surgeries or were unfit for pneumoperitoneum were excluded. The preoperative, intraoperative, and postoperative data were prospectively collected. RARP was performed through 5 ports (12 mm); 3 for the robotic arms, 1 for the camera, and 1 for the assistant surgeon. Repeated adjustments of the patient's position and port distribution along with the bedside unit's configuration, arrangement, and orientation were made until an optimal setup was achieved. The technical malfunctions were identified in each case and fixed in the subsequent ones. All patients were invited to the follow-up clinic for routine visits on the first and second weeks following surgery and then every month for three months.

Results: Thirty patients underwent the procedure without conversion to laparoscopy or open surgery and abided by the follow-up regimen. The first nine cases required frequent setup adjustments due to recurring alarms and arms-related conflicts. Thenceforth, the mean docking time, console time, urethro-vesical anastomosis time, and total operative time were enhanced in the last 21 cases without system alarms. No major intraoperative complications related to the robotic system utilization were reported. The postoperative course of all participants passed uneventfully. The median length of the hospital stay and catheterization time were 2 (1-2) and 7 (7-10) days, respectively.

Conclusion: The Versius system offers a promising robotic platform with a flexible surgical setup. The proposed setup provides a guide for a smooth performance in RARP with minimal instruments' collision to eschew system failure. Being the first generation of this surgical robotic system, future efforts are still needed to improve its performance and minimize its drawbacks.

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来源期刊
Arab Journal of Urology
Arab Journal of Urology UROLOGY & NEPHROLOGY-
CiteScore
2.80
自引率
0.00%
发文量
40
期刊介绍: The Arab Journal of Urology is a peer-reviewed journal that strives to provide a high standard of research and clinical material to the widest possible urological community worldwide. The journal encompasses all aspects of urology including: urological oncology, urological reconstructive surgery, urodynamics, female urology, pediatric urology, endourology, transplantation, erectile dysfunction, and urinary infections and inflammations. The journal provides reviews, original articles, editorials, surgical techniques, cases reports and correspondence. Urologists, oncologists, pathologists, radiologists and scientists are invited to submit their contributions to make the Arab Journal of Urology a viable international forum for the practical, timely and state-of-the-art clinical urology and basic urological research.
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