汪 洋,唐文博,王兆海

目的：单通道机器人手术自开展以来，手术方式已由最初的简单手术发展到目前的复杂手术。胰十二指肠切除术作为肝胆胰外科最复杂的手术之一，使用单通道机器人完成具备很高的难度。本中心作为世界首例单通道机器人胰腺手术的实施单位，总结前期经验，希望对早期开展单通道机器人胰十二指肠切除术的的医师有所帮助。方法：本中心自2021年12月至2023年6月共完成单通道机器人胰腺手术67例，其中胰十二指肠切除术9例。结合术中操作体验及所遇问题不断优化，改善操作舒适度，多方兼顾，提高手术效率，减少中转率，总结经验。结果：总结单通道机器人胰十二指肠切除术的最佳适应症、手术布孔及操作步骤，并对其中要点进行逐一分析与教学。

单通道机器人；胰十二指肠切除术；教学；临床实践

[1]osemurgy A, Ross S, Bourdeau T, et al. Robotic Pancreaticoduodenectomy Is the Future: Here and Now. J Am Coll Surg. 2019;228(4):613-624. [2].Mantzavinou A, Uppara M, Chan J, Patel B. Robotic versus open pancreaticoduodenectomy, comparing therapeutic indexes; a systematic review. Int J Surg. 2022;101:106633. [3]刘荣,汪洋,赵国栋,等.单通道机器人肝胰手术初步临床实践与评价[J/CD]中华腔镜外科杂志(电子版),2021,14(6):321-325. [4]汪洋,刘荣.单通道机器人肝胆胰手术布孔策略[J].中华腔镜外科杂志(电子版),2023,16(3):129-130. [5]Liu R , Zhao G D , Zhang X P , et al. The first case report of single-port robot-assisted pancreatectomy using the da Vinci SP system[J]. Intelligent Surgery, 2022, 1:32-35. [6]Liu R, Zhao G D , Zou W B , et al. Single-port robot-assisted hepatic left lateral sectionectomy using the da Vinci SP system: A case report[J]. Intelligent Surgery, 2022,2:6-9. [7]Khachfe HH, Nassour I, Hammad AY, et al. Robotic Pancreaticoduodenectomy: Increased Adoption and Improved Outcomes: Is Laparoscopy Still Justified?. Ann Surg. 2023;278(3):e563-e569. [8]Nickel F, Wise PA, Müller PC, et al. Short-term Outcomes of Robotic Versus Open Pancreatoduodenectomy: Propensity Score-matched Analysis. Ann Surg. 2024;279(4):665-670. [9]Rosemurgy A, Ross S, Bourdeau T, et al. Cost Analysis of Pancreaticoduodenectomy at a High-Volume Robotic Hepatopancreaticobiliary Surgery Program. J Am Coll Surg. 2021;232(4):461-469. [10]Takagi K, Umeda Y, Fuji T, Yasui K, Fujiwara T. Robotic Pancreaticoduodenectomy Using the Right Posterior Superior Mesenteric Artery Approach. J Gastrointest Surg. 2023;27(12):3069-3070. [11]Jang JY, Chong EH, Kang I, Yang SJ, Lee SH, Choi SH. Laparoscopic pancreaticoduodenectomy and laparoscopic pancreaticoduodenectomy with robotic reconstruction: single-surgeon experience and technical notes. J Minim Invasive Surg. 2023;26(2):72-82. [12]Choi M, Rho SY, Kim SH, Hwang HK, Lee WJ, Kang CM. Total laparoscopic versus robotic-assisted laparoscopic pancreaticoduodenectomy: which one is better?. Surg Endosc. 2022;36(12):8959-8966.

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