机器人辅助胰体尾切除：从切脾到保脾

目的 回顾性分析15例行胰腺机器人手术患者的资料,探讨达芬奇机器人辅助外科系统在胰腺外科领域中的运用.方法：达芬奇机器人辅助开展15例胰体尾切除手术,5例实施胰体尾联合脾切除,10例开展保留脾脏的胰体尾切除术,分析手术时间、术中出血、术后并发症和出院时间等相关指标.结果 15例手术均顺利完成,无中转开腹.术中平均出血量在213 ml,平均手术总用时276 min,平均手术时间242 min,均未输血.术后并发症发生率26.67％.后期开展的10例保脾胰体尾切除手术均成功保留了脾血管和脾脏.结论 机器人手术系统是传统腔镜手术的一个巨大飞跃,能够实现更精细的微创手术操作,实现外科手术中脏器和功能的保留,在胰腺外科领域更能体现其优势和特点,因此有着非常广阔的运用前景.

Robotic distal pancreatectomy： from joint splenectomy to spleen preserving

Objective A retrospective review of 15 patients who underwent robotic surgery for pancreatic disease was performed, to study the use of Da Vinci robot-assisted surgical system to use in the field of pancreatic surgery. Methods 15 cases were performed distal pancreateetomy by Da Vinci robot assisted surgical system. 5 cases were carried out pancreatic body and tail joint splenectomy： 10 cases were carried out spleen preserving resection of the pancreatic body and tail. Analytic parameter include operation time, blood loss and postoperative complications, discharge time and other surgery-related indicators. Results Fifteen cases were operated successfully and not conversions to open surgery. The estimated blood loss was 213 ml. The mean total surgical time was 276 minutes, and mean operative time 242 minutes, no blood transfusion. Postoperative complications occurred in 4 （26.67%） patients. 10 cases were carried out spleen-preserving distal pancreatectomy with the splenic arteriovenous retained. Conclusion Robotic Surgical System is a huge leap forwards to the traditional laparoscopic surgery, which enabled more precise minimally invasive surgical procedures, achieve organ and function preservation, better reflect its advantages and characteristics in the field of pancreatic surgery. It is believed that this technique be very broad application prospects.