One Hundred Eighty Cases of General Surgeries Under da Vinci Surgical System in Single Institute in China_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHOU Ningxin , CHEN Junzhou , LIU Quanda , ZHANG Xiaodong , ZHANG Tao , CHEN Zefeng.

Institute of Hepatobiliary and Gastrointestinal Surgery, General Hospital of The Second Artillery Corps of Chinese PLA, Beijing 100088, China;

Corresponding author：

Keywords：

da Vinci surgical system; Robotic surgery; Minimally invasive surgery; General surgery; Hepatobiliary pancreatic surgery; Liver

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ObjectiveTo summarize the clinical experience of 180 general surgeries under da Vinci surgical system. MethodsFrom January 2009 to October 2010, 180 patients with hepatopancreaticobiliary and gastrointestinal disease underwent robotic surgeries by using da Vinci surgical system. The case distribution, intra-and post-operative data were analyzed. ResultsA total of 171 patients had underwent total robotic surgeries and nine patients converted to hand-assisted procedure (5.0%, 9/180). The surgery for hepatic portal was performed in 63 cases of patients, including surgery for hilar cholangiocarcinoma in 36 cases, gallbladder carcinoma in 10 cases, complex calculus of intrahepatic duct in 12 cases, and iatrogenic biliary duct injury in 5 cases. The pancreatic surgery was performed in 44 cases of patients, including pancreatoduodenectomy in 16 cases, distal pancreatectomy in 6 cases, medial pancreatectomy in 1 case, pancreatic cyst-jejunum anastomosis in 1 case, and palliative surgery in 20 cases. Hepatic surgery was in 19 cases and gastrointestinal surgery in 12 cases of patients. Other procedures were in 42 cases of patients, including common bile duct exploration and removing the stone, retroperitoneal lymph nodes dissection, and splenectomy, etc. All of ten cases of patients with obstructive suppurative cholangitis received emergency surgery by the robot and postoperative infection symptoms were controlled, and shock was corrected quickly. No death occurred during the perioperative period. Postoperative complications occurred in 12 cases (6.7%, 12/180) and 2 cases died (1.1%, 2/180). Conclusionsda Vinci surgical system can carry out all kinds of general surgery, especially complicated and difficult hepatobiliary and pancreatic surgery, which improves the development of minimally invasive surgery.

Citation： ZHOU Ningxin,CHEN Junzhou,LIU Quanda,ZHANG Xiaodong,ZHANG Tao,CHEN Zefeng.. One Hundred Eighty Cases of General Surgeries Under da Vinci Surgical System in Single Institute in China. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(7): 698-704. doi: Copy

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2.	Kaushik D, High R, Clark CJ, et al. Malfunction of the Da vinci robotic system during robotassisted laparoscopic prostatectomy: an international survey [J]. J Endourol, 2010, 24(4): 571575.
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12.	Hwang SH, Park DJ, Jee YS, et al. Actual 3year survival after laparoscopyassisted gastrectomy for gastric cancer [J]. Arch Surg, 2009, 144(6): 559564.
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22.	郑民华．中国腹腔镜外科的现状与进展 [J]．中华腔镜外科杂志(电子版)， 2010， 3（1）： 16．.
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1. Lanfranco AR, Castellanos AE, Desai JP, et al. Robotic surgery: a current perspective[J]. Ann Surg, 2004, 239(1): 1421.
2. Kaushik D, High R, Clark CJ, et al. Malfunction of the Da vinci robotic system during robotassisted laparoscopic prostatectomy: an international survey [J]. J Endourol, 2010, 24(4): 571575.
3. 郑树国，李建伟，陈健，等．应用达芬奇机器人手术系统治疗壶腹部癌 [J]．中华消化外科杂志， 2010， 9（2）： 112113．.
4. 纪文斌，赵之明，王宏光，等．达芬奇机器人手术系统在肝胆胰外科的应用 [J]．中华消化外科杂志， 2010， 9（2）： 109111．.
5. Narula VK, Mikami DJ, Melvin WS. Robotic and laparoscopic pancreaticoduodenectomy: a hybrid approach [J]. Pancreas, 2010, 39(2): 160164.
6. 陈军周，周宁新，刘全达，等．达芬奇机器人手术系统再手术入路的选择 [J]．中华消化外科杂志， 2010， 9（2）： 105108．.
7. 余佩武，钱锋，曾冬竹，等．达芬奇机器人手术系统胃癌根治术五例报告 [J]．中华外科杂志， 2010， 48（20）： 15921594．.
8. 黄志强. 3D时代的肝胆外科：从“阿童木”到“阿凡达” [J]. 中华腔镜外科杂志（电子版）， 2010， 3（3）： 218220.
9. Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery:personal experience in a large community hospital [J]. Arch Surg, 2003, 138(7): 777784.
10. 吴继敏，汪忠镐，季锋，等．腹腔镜Nisssen胃底折叠术治疗胃食管反流病 [J]．中华普外科杂志， 2009， 18（10）： 10551058．.
11. Khatlani K, Sharma S, Mendoza PJ, et al. The current state of robot assisted radical prostatectomy [J]. Minerva Urol Nefrol, 2010, 62(2): 193201.
12. Hwang SH, Park DJ, Jee YS, et al. Actual 3year survival after laparoscopyassisted gastrectomy for gastric cancer [J]. Arch Surg, 2009, 144(6): 559564.
13. Shim JH, Song KY, Kim SN, et al. Laparoscopyassisted distal gastrectomy for overweight patients in the asian population[J]. Surg Today, 2009, 39(6): 481486.
14. Francescutti V, Choy I, Biertho L, et al. Gastrectomy and esophagogastrectomy for proximal and distal gastric lesions: a comparison of open and laparoscopic procedures [J]. Surg Innov, 2009, 16(2): 134139.
15. Strong VE, Devaud N, Allen PJ, et al. Laparoscopic versus open subtotal gastrectomy for adenocarcinoma: a casecontrol study [J]. Ann Surg Oncol, 2009, 16(6): 15071513.
16. 余佩武．腹腔镜胃癌根治术的原则与评价 [J]．中国普外基础与临床杂志， 2009， 16（1）： 15．.
17. 周宁新，陈军周，刘全达，等．达芬奇机器人手术系统和开腹胰十二指肠切除术的比较 [J]．中华消化外科杂志， 2010， 9（2）： 101104．.
18. Huettner F, Dynda D, Ryan M, et al. Roboticassisted minimally invasive surgery; a useful tool in resident training—the peoria experience, 20022009 [J]. Int J Med Robot, 2010, 6(4): 386393.
19. Jayaraman S, Davies W, Schlachta CM. Getting started with robotics in general surgery with cholecystectomy:the canadian experience [J]. Can J Surg, 2009, 52(5): 374378.
20. Hashizume M, Tsugawa K. Robotic surgery and cancer: the present state, problems and future vision [J]. Jpn J Clin Oncol, 2004, 34(5): 227237.
21. Camarillo DB, Krummel TM, Salisbury JK. Robotic technology in surgery: past, present, and future [J]. Am J Surg, 2004, 188(4A Suppl): 2S15S.
22. 郑民华．中国腹腔镜外科的现状与进展 [J]．中华腔镜外科杂志(电子版)， 2010， 3（1）： 16．.
23. Chen CC, Falcone T. Robotic gynecologic surgery: past, present, and future [J]. Clin Obstet Gynecol, 2009, 52(3): 335343.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

One Hundred Eighty Cases of General Surgeries Under da Vinci Surgical System in Single Institute in China

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