<i>EDGE SP1000</i>单孔手术机器人辅助腹腔镜下猪输尿管部分切除联合端端吻合术的可行性研究

doi:10.3877/cma.j.issn.1674-3253.2023.06.018

目的

利用活体猪模型评估EDGE SP1000单孔机器人辅助腹腔镜输尿管部分切除联合端端吻合术的安全性和可行性。

方法

利用EDGE SP1000单孔机器人手术系统开展腹腔镜下猪输尿管部分切除联合端端吻合术。监测手术过程中猪的生命体征，记录手术困难点和并发症，观察术后2周猪的存活情况。

结果

所有猪均存活至术后两周，手术过程中未出现并发症，也未遇到技术困难。5头猪建立手术通道的平均时间为（15.0±1.2）min，安装EDGE SP1000单孔手术机器人系统时间为（5.6±0.6） min，输尿管部分切除时间为（8.8±1.3） min，输尿管端端吻合时间为（39.2±2.3） min，总手术时间为（89±5） min，术中出血量为（1.20±0.24）mL。使用该手术系统的外科医师和助手均对系统的工作给予了高度评价。

结论

本研究证实EDGE SP1000单孔机器人手术系统用于猪输尿管部分切除联合端端吻合术是安全可行的。下一步拟开展EDGE SP1000系统在其他外科手术中的安全性和有效性评价，提供更多可靠的临床前数据支撑。

关键词: 单孔手术，机器人, 机器人辅助腹腔镜, 输尿管部分切除, 端端吻合, 活体猪

Objective

To evaluate the safety and feasibility of using the EDGE SP1000 single-port surgical robot for laparoscopic partial ureterectomy with end-to-end anastomosis in a live pig model.

Methods

The EDGE SP1000 single-port robotic surgical system was used to perform laparoscopic partial ureterectomy with end-to-end anastomosis in pigs. Vital signs of the pigs were monitored during the surgery, and surgical difficulties and complications were recorded. The survival of the pigs was observed for two weeks post-operatively.

Results

All pigs survived for two weeks after the surgery, with no surgical complications or technical difficulties encountered during the procedure. The average time for establishing the surgical access in five pigs was (15.0±1.2) min, while the installation time for the EDGE SP1000 single-port surgical robot system was also (5.6±0.6) min. The time for ureterectomy was (8.8±1.3) min, the time for end-to-end anastomosis of the ureter was (39.2±2.3) min, and the total surgical time was (89±5) min, and intraoperative blood loss was (1.20±0.24) mL. The surgical team highly praised the performance of the surgical system.

Conclusion

This study confirms that the EDGE SP1000 single-port robotic surgical system is safe and feasible for laparoscopic partial ureterectomy with end-to-end anastomosis in pigs. The next step is to evaluate the safety and effectiveness of the EDGE SP1000 system in other surgical procedures, providing more reliable preclinical data support.

Key words: Single-port surgical, robot, Robotic-assisted laparoscopy, Partial ureterectomy, End-to-end anastomosis, Live pig

图1 　EDGE SP1000单孔机器人手术系统（医师主控台、手术机械臂推车和三维高清影像系统）

图2　输尿管部分切除联合端端吻合手术中机器人外景　图3　输尿管部分切除联合端端吻合手术关键步骤　图4　输尿管部分切除联合端端吻合术缝合后切口注：图2a为套管位置示意（A为助手孔位置，C为单孔套管位置，T为左侧肋腰角位置）；2b为安装单孔腔镜保护套；2c为单孔机器人术中套管位置外景；2d为单孔机器人术中操作外景。图3a为打开腹膜，进入腹膜后间隙；3b为游离并显露输尿管；3c为吻合好后壁，置入双J管；3d为输尿管端端吻合结束

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Feasibility study of EDGE SP1000 single hole surgical robot assisted laparoscopic partial ureterectomy with end-to-end anastomosis in pigs

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Feasibility study of EDGE SP1000 single hole surgical robot assisted laparoscopic partial ureterectomy with end-to-end anastomosis in pigs