- 期刊
Automated Endoscopic System for Optimal Positioning-assisted Mini-laparoscopic Cholecystectomy: Preliminary Report
伊索機器手臂輔助迷你腹腔鏡膽囊切除術：初步經驗
摘要
迷你腹腔鏡膽囊切除手術比傳統腹腔鏡膽囊切除手術需要更高超的技巧及較多的人力，以聲控操作伊索機器手臂AESOP(Automated Endoscopic System for Optimal Positioning)來協助迷你腹腔鏡膽囊切除手術之可行性尚未建立，此研究目的在於比較以伊索機器手臂協助與助手協助之迷你腹腔鏡膽囊切除手術兩組結果。 以伊索機器手臂協助迷你腹腔鏡膽囊切除手術共28位病人，其手術結果與從前以助手協助迷你腹腔鏡膽囊切除手術的28位病人做比較。分析的資料包括病人年齡、性別、手術適應症、體質指標BMI、準備時問、開刀時問、住院天數、及手術併發症。 兩組病人之性別年齡相似，總共有48位病人成功接受迷你腹腔鏡膽囊切除手術。以助手協助迷你腹腔鏡膽囊切除手術的一組，有五位需要將其中一枝2mm套管改為5mm或10mm套管才能完成手術，而以伊索機器手臂協助迷你腹腔鏡膽囊切除手術那組，共有三位。兩組病人恢復狀況良好，準備時問也沒有統計學上的差異(p=0.186)。以伊索機器手臂協助迷你腹腔鏡膽囊切除手術那組平均手術時間是43.39±20.45分鐘，明顯比助手協助迷你腹腔鏡膽囊切除手術那組的64.46±26.78分鐘短(p=0.0008)。兩組都沒有膽道損傷的併發症，住院天數、恢復進食的時間、及使用麻醉性止痛劑的量兩組也沒有差異。 總之，和助手協助迷你腹腔鏡膽囊切除手術比較起來，伊索機器手臂藉由提供穩定的掌鏡平台及避免不必要的動作，使得迷你腹腔鏡膽囊切除手術更容易進行。
關鍵字
無資料並列摘要
Objective: The use of mini-instruments in laparoscopic cholecystectomy (LC) was more technique-demanding and manpower-demanding than conventional LC. The feasibility of using a vocally controlled manipulator AESOP (Automated Endoscopic System for Optimal Positioning) to assist mini-LC, however, has not been established as yet. This study compared the outcome of AESOP-assisted mini-LC (A-MLC) with that of human-assisted mini-LC (M-MLC). Methods: The outcomes of 28 patients undergoing M-MLC were compared with those of a subsequent series of 28 patients undergoing A-MLC. Patient demographics including surgical indications, body mass index, and peri-operative parameters such as preparation time, operation time, hospital stay, and surgical complications were compared between the two groups. Results: The patient demographics were similar between the two groups. MLC was successfully performed in 48 patients. Three patients in the A-MLC group and five patients in the M-MLC group had to change one of the 2 mm working ports to a 5 or 10 mm working port to complete the procedures. Both approaches resulted in good recovery. The mean preparation time in A-MLC (22.93±10.50 minutes) was shorter than that in M-MLC (25.21±8.38) minutes, but the difference was not statistically significant. The mean operation time in A-MLC (43.39±20.45 minutes) was significantly shorter than that in M-MLC (64.46±26.78 minutes). No biliary tract complications were recorded in either group. The length of hospital stay, resumption of diet, and the use of narcotic analgesics were not significantly different between the two groups. Conclusions: As compared with a human-assisted surgery, AESOP facilitated the performance of mini-laparoscopic cholecystectomy by providing a stable camera platform and avoiding unwanted movement during the laparoscopic procedure.
延伸閱讀
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