达芬奇机器人在后上纵隔神经源性肿瘤手术中的应用

摘要

The paper reported 6 patients with neurogenic tumor of upper posterior mediastinum underwent resection with daVinci surgical system between March 2011 and October 2012.The operations were employed by using three arms without an auxiliaryport.The left robotic hand manipulated bipolar coagulation forceps , and the right hand manipulated a coagulation hook .The operativetime was 60 -215 min (mean, 127.5 min), the dissection time was 10 -90 min (mean, 45.0 min), the intraoperative blood losswas 5 -50 ml (mean, 24.2 ml), the volume of close thoracic drainage within postoperative 24 hours was 30 -210 ml (mean, 86.7ml), the postoperative drainage time was 1 -6 d (mean, 4.3 d).All the operations were successfully completed , without conversionto thoracotomy.One patient developed an incomplete Hornor ’s syndrome after operation, and two patients had hypohidrosis.Theremaining patients recovered smoothly.We deem that the application of da Vinci surgical system for neurogenic tumor of upper posteriormediastinum is safe and feasible.%本文报道2011年3月～2012年10月应用达芬奇机器人手术切除后上纵隔神经源性肿瘤6例。采用三臂法，机械臂左手使用双极电凝抓钳，右手使用电凝钩，不使用辅助操作孔。6例均通过机器人成功完成手术，无中转开胸。手术时间60～215 min，平均127．5 min；分离时间10～90 min，平均45．0 min；术中出血量5～50 ml，平均24．2 ml；术后24 h引流量30～210 ml，平均86．7 ml；术后引流管留置时间1～6 d，平均4．3 d。术后1例出现不全霍纳综合征，2例出现术侧上肢出汗减少，其余均恢复良好出院。我们认为达芬奇机器人手术治疗后上纵隔肿瘤手术安全可行。