中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
CHINESE JOURNAL OF ENDOCRINE SURGERY
2014年
4期
328-331
,共4页
贺青卿%庄大勇%范子义%周鹏%郑鲁明%朱见%侯蕾%于芳%李燕宁%肖蕾%张海涛%张鲁
賀青卿%莊大勇%範子義%週鵬%鄭魯明%硃見%侯蕾%于芳%李燕寧%肖蕾%張海濤%張魯
하청경%장대용%범자의%주붕%정로명%주견%후뢰%우방%리연저%초뢰%장해도%장로
达芬奇机器人外科手术系统%机器人甲状腺手术%腋窝径路%胸前径路
達芬奇機器人外科手術繫統%機器人甲狀腺手術%腋窩徑路%胸前徑路
체분기궤기인외과수술계통%궤기인갑상선수술%액와경로%흉전경로
da Vinci Si surgical system%Robotic thyroidectomy%Trans-axillary approach%Anteri-or chest approach
目的：达芬奇机器人（ da Vinci Si ）外科手术系统下单腋窝切口和胸前径路行猪甲状腺切除术，观察其安全性并积累手术操作经验。方法 da Vinci Si外科手术系统包括医生操控系统、床旁机械臂系统和成像系统。手术器械凭借腋窝/胸壁的切口连接到机器人的机械臂。术者坐于操控台前将手指分别放入操作手柄的指套内联合双脚控制手术器械和双目内窥镜，它可将外科医生的动作转换传递到手术器械的尖端。内置模拟手腕系统（ EndoWrist ）技术可使机械手进行上下左右旋转等7个自由的连续动作，超过了人手在开放手术时的灵活性。本组选用2头小型猪做da Vinci Si外科手术系统不同径路的甲状腺切除动物模型。采用气管插管全身麻醉。结果在da Vinci Si外科手术系统下完成2例不同径路的猪甲状腺切除和胸腺切除术。无中转开放或腔镜手术。手术时间分别为61 min和50 min。结论有开放性甲状腺外科手术经验的专科医师经短期da Vinci Si外科手术系统培训即可实施甲状腺腺叶切除术。在da Vinci Si外科手术系统辅助下行甲状腺切除术的学习曲线短。
目的：達芬奇機器人（ da Vinci Si ）外科手術繫統下單腋窩切口和胸前徑路行豬甲狀腺切除術，觀察其安全性併積纍手術操作經驗。方法 da Vinci Si外科手術繫統包括醫生操控繫統、床徬機械臂繫統和成像繫統。手術器械憑藉腋窩/胸壁的切口連接到機器人的機械臂。術者坐于操控檯前將手指分彆放入操作手柄的指套內聯閤雙腳控製手術器械和雙目內窺鏡，它可將外科醫生的動作轉換傳遞到手術器械的尖耑。內置模擬手腕繫統（ EndoWrist ）技術可使機械手進行上下左右鏇轉等7箇自由的連續動作，超過瞭人手在開放手術時的靈活性。本組選用2頭小型豬做da Vinci Si外科手術繫統不同徑路的甲狀腺切除動物模型。採用氣管插管全身痳醉。結果在da Vinci Si外科手術繫統下完成2例不同徑路的豬甲狀腺切除和胸腺切除術。無中轉開放或腔鏡手術。手術時間分彆為61 min和50 min。結論有開放性甲狀腺外科手術經驗的專科醫師經短期da Vinci Si外科手術繫統培訓即可實施甲狀腺腺葉切除術。在da Vinci Si外科手術繫統輔助下行甲狀腺切除術的學習麯線短。
목적：체분기궤기인（ da Vinci Si ）외과수술계통하단액와절구화흉전경로행저갑상선절제술，관찰기안전성병적루수술조작경험。방법 da Vinci Si외과수술계통포괄의생조공계통、상방궤계비계통화성상계통。수술기계빙차액와/흉벽적절구련접도궤기인적궤계비。술자좌우조공태전장수지분별방입조작수병적지투내연합쌍각공제수술기계화쌍목내규경，타가장외과의생적동작전환전체도수술기계적첨단。내치모의수완계통（ EndoWrist ）기술가사궤계수진행상하좌우선전등7개자유적련속동작，초과료인수재개방수술시적령활성。본조선용2두소형저주da Vinci Si외과수술계통불동경로적갑상선절제동물모형。채용기관삽관전신마취。결과재da Vinci Si외과수술계통하완성2례불동경로적저갑상선절제화흉선절제술。무중전개방혹강경수술。수술시간분별위61 min화50 min。결론유개방성갑상선외과수술경험적전과의사경단기da Vinci Si외과수술계통배훈즉가실시갑상선선협절제술。재da Vinci Si외과수술계통보조하행갑상선절제술적학습곡선단。
Objective To evaluate the safety of the da Vinci Si surgical system in thyroid surgery and to accumulate operation experience .Methods The da Vinci Si surgical system consists of a surgeon's console, a patient-side robotic cart, and high-definition 3D vision system.The robot arm tips were introduced via a single axillary incision or small chest wall ports and attached to the arms of the robot .The surgeon , sitting at the con-sole, manipulated the EndoWrist instruments and endoscope view that transfer the surgeon 's movements to the arm tips.The so called EndoWrist'technology offers seven degrees of movements ( up, down, left, right, twist, et al) , thus exceeding the capacity of a surgeon's hand in open surgery .The da Vinci Si surgical system was used to perform thyroidectomy in two small pigs .The animals were intubated and kept anesthetized with halothane .Re-sults Four surgical procedures were done using the da Vinci Si system from beginning to the end , including 2 thyroidectomies and 2 thymectomies .No conversions to open or laparoscopic procedure was used .The procedure length was 61 minutes and 50 minutes, respectively.Conclusions Robotic thyroidectomy can be performed safe-ly by the experienced surgeons after short-term da Vinci Si surgical system training .The learning curve for robotic thyroidectomy is shorter .
