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机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征6例

Robotic-assisted“3+1”Surgical Mode Strategy for 6 Cases of Median Arcuate Ligament Syndrome
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摘要 目的探讨机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征(median arcuate ligament syndrome,MALS)的可行性。方法2019年6月~2023年10月我们采用机器人辅助下“3+1”手术模式治疗6例MALS。采用机器人辅助“3+1”手术模式(3个机械臂和1个助手孔的四孔操作方法),通过腹腔干血管游离方式,经脾动脉后方入路,解除正中弓状韧带对腹腔干的压迫。结果6例均成功完成机器人辅助下“3+1”模式手术。手术操作时间(包括接机和撤机的时间)38~52 min,平均43.2 min;术中出血量5~25 ml,平均15 ml。术后住院时间6~9 d,平均7.5 d。6例术后随访1~45个月(中位随访时间2.5月),1例体重未变,5例体重增加1.0~2.0 kg,平均1.5 kg;5例餐后上腹痛症状完全消失,1例症状减轻但未完全缓解。结论机器人辅助下“3+1”手术模式经脾动脉后方入路腹腔干血管游离方式治疗MALS安全可行。 Objective To investigate the feasibility of robotic-assisted“3+1”surgical mode strategy for the treatment of median arcuate ligament syndrome(MALS).Methods Six patients diagnosed as MALS were enrolled between June 2019 and October 2023.The utilization of robotic-assisted“3+1”surgical mode(a 4-hole operation with 3 robot arms and 1 assistance hole)was carried out.Through a posterior splenic artery approach,the compression of the midline arcuate ligament on the abdominal trunk was relieved,which was an abdominal trunk vascularization.Results All the 6 patients underwent robotic-assisted“3+1”surgical mode successfully.The surgical duration(including the time for connecting and disconnecting the machine)was 38-52 min,with a mean of 43.2 min.The intraoperative bleeding volume was 5-25 ml,with a mean of 15 ml.The postoperative hospital stay was 6-9 d,with a mean of 7.5 d.All the 6 patients were followed up for 1-45 months after surgery(median,2.5 months).One patient remained unchanged in body weight,while 5 patients gained 1.0-2.0 kg in body weight,with a mean of 1.5 kg.The symptom of postprandial epigastric pain completely resolved in 5 patients,while the symptom was reduced but not completely alleviated in one patient.Conclusion Treatment of MALS with the robotic-assisted“3+1”surgical model involving abdominal trunk vascularization through a posterior splenic artery approach is safe and feasible.
作者 马于祺 马云涛 马雕龙 杨婧 詹渭鹏 蔡辉 狐鸣 Ma Yuqi;Ma Yuntao;Ma Diaolong(Department of General Surgery,Gansu Provincial People’s Hospital,Lanzhou 730000,China)
出处 《中国微创外科杂志》 CSCD 北大核心 2024年第10期678-682,共5页 Chinese Journal of Minimally Invasive Surgery
基金 国家卫健委胃肠肿瘤诊治重点实验室课题(NLDTG2022009) 甘肃省自然科学基金项目(22JR5RA663)。
关键词 正中弓状韧带综合征 机器人手术 Median arcuate ligament syndrome Robotic-assisted surgery
作者简介 通讯作者:狐鸣,E-mail:3575515665@qq.com。
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