国产单孔机器人辅助腹腔镜根治性前列腺切除术的初步应用

doi:10.3877/cma.j.issn.1674-3253.2025.05.004

目的

本研究旨在探讨国产单孔机器人（精锋）辅助腹腔镜经腹膜外入路根治性前列腺切除术（SP-RARP）在局限性前列腺癌（PCa）治疗中的安全性及临床疗效。

方法

回顾性分析2025年3月安徽医科大学第一附属医院10例接受经腹膜外SP-RARP患者的临床资料。手术方式采用经腹膜外入路SP-RARP，收集患者年龄、体质量指数（BMI）、前列腺体积、术前前列腺特异性抗原（PSA）、Gleason评分，以及手术时间、出血量、疼痛评分、通气时间等指标。

结果

10例患者均顺利完成手术，年龄中位数为69（60，77）岁；BMI中位数为23.9（23.3，24.8）kg/m²；术前PSA中位数为9.5（6.3，13.5）ng/mL；术前前列腺体积中位数为32.4（23.3，36.9）cm³；围术期的指标中，手术时间中位数为148（124，195）min；术中出血量中位数为75.0（47.5，97.5）mL；通气时间中位数为1.5（1.0，2.0）d；恢复流质饮食时间中位数为2（1，2）d；住院天数中位数为4.0（3.0，4.3）d；所有患者均未发现术后病理切缘阳性，围术期均无中转开放或严重并发症。

结论

国产精锋单孔机器人经腹膜外入路根治性前列腺切除可能是一种安全有效的微创手术方式，但仍需大样本、多中心、随机对照临床研究进一步验证其有效性、安全性。

关键词: 国产，单孔，机器人, 前列腺切除术, 经腹膜外入路, 前列腺癌

Objective

To evaluate the safety and clinical efficacy of the domestic "Jingfeng" single-port robot-assisted laparoscopic extraperitoneal radical prostatectomy (SP-RARP) in the treatment of localized prostate cancer (PCa).

Methods

A retrospective analysis was conducted on the clinical data of 10 patients who underwent extraperitoneal SP-RARP at the First Affiliated Hospital of Anhui Medical University in March 2025. The surgical approach was extraperitoneal SP-RARP. The data were collected included patients' age, body mass index (BMI), prostate volume, preoperative prostate-specific antigen (PSA), Gleason score, and perioperative indicators such as surgery time, blood loss, pain score, and ventilation time.

Results

All 10 patients were successfully completed the surgery, with a median age of 69(60, 77) years. The median BMI was 23.9(23.3, 24.8) kg/m².The median preoperative PSA was 9.5(6.3, 13.5) ng/mL, and the median preoperative prostate volume was 32.4(23.3, 36.9) cm³. In terms of perioperative indicators, the median surgery time was 148(124, 195) minutes, the median intraoperative blood loss was 75.0(47.5, 97.5) mL, the median ventilation time was 1.5(1.0, 2.0) days, the median time to liquid diet recovery was 2(1, 2) days, and the median hospital stay was 4.0(3.0, 4.3) days. The postoperative pathological margins of all patients were negative, and there were no intraoperative conversions to open surgery or severe complications.

Conclusion

Domestic "Jingfeng" single-port robot-assisted extraperitoneal radical prostatectomy is a safe and effective minimally invasive surgical technique. However, further large-scale, multi-center, randomized controlled trials are needed to validate its efficacy and safety.

Key words: Domestic, single port, robot, Prostatectomy, Extraperitoneal approach, Prostate cancer

图1 国产精锋单孔机器人手术系统组成注：a为影像处理平台；b为患者手术平台；c为术者控制台

图2 采用国产精锋单孔机器人行前列腺癌根治术术前准备注：a为患者取正向Trendelenburg体位；b为单孔多通道接口和辅助套管的定位；c为单孔多通道接口安装；d为单孔机器人机械臂与接口连接

图3 采用国产精锋单孔机器人行前列腺癌根治术手术步骤注：a为游离Retzius间隙；b为缝扎背深静脉复合体；c为离断膀胱颈口；d为处理输精管及精囊；e为结扎双侧神经血管束；f为游离、离断前列腺尖部尿道；g为吻合尿道及膀胱颈口；h为逐层缝合并放置引流管。

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Clinical application of domestic single-port robot-assisted laparoscopic radical prostatectomy

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Clinical application of domestic single-port robot-assisted laparoscopic radical prostatectomy