RESUMO
Objective To explore the technique of single port laparoscopy assisted by the third generation SI class Da Vinci robot in treatment of gynecological malignant tumors. Methods The clinical data were retrospectively analyzed of 8 patients with robot-assisted single port laparoscopy of gynecological malignant tumor from June to August 2018 in Changzheng Hospital. Of the 8 patients [aged 34–51 (43±6) years and BMI of 20.1–26.3 (23.2±3.1) kg/m2], 4 were early endometrial cancer and another 4 were early cervical cancer. With the help of porous instruments of ordinary robot system and Lagiport single-site multi-channel platform, the third generation SI class Da Vinci robotic surgical system was used to complete the robot assisted transumbilical single port laparoscopic surgery. Four patients with early endometrial cancer received total hysterectomy + double-adnexy resection + sentinel lymph node biopsy, and another 4 with early cervical cancer received radical resection of cervical carcinoma. Results Robot assisted single port laparoscopic surgery was successfully performed in all 8 patients with no additional auxiliary puncture port or laparotomy. The operation time was (208±68) min, and the intraoperative blood loss was (155±71) ml. No injury of ureter, bladder, rectum and obturator nerve and blood transfusion occurred during operation. No postoperative complications occurred such as blood transfusion, persistent fever, wound exudation, pelvic and abdominal infection and deep venous thrombosis. Four patients with endometrial cancer were discharged 4 days after operation, and another 4 with cervical cancer were discharged 7 days after operation. All patients were satisfied with the wound after operation. Conclusion The third generation SI-class Da Vinci robot can complete gynecological malignant tumor surgery with the help of ordinary robot instruments and Lagiport single-site multi-channel platform, which is one of the effective surgical methods for gynecological malignant tumor.
RESUMO
Objective: To analyze the clinical and operative situations of radical hysterectomy in 440 cervical cancer patients. Methods: The clinical and operative situations were retrospectively evaluated in 440 cervical cancer patients. All the patients received radical hysterectomy and pelvic lymphadenectomy by the Wertheim-Okabayashi procedure. Results: The average age of the patients was 43.9 (21-78) years old and the mean body mass index (BMI) was 23.2(15.8-47.3) kg/m2. Histologic classification included: 353 cases (80.2%) of squamous cell carcinoma, 56 (12.8%) cases of adenocarcinoma, 20 (4.6%) cases of adeno-squamous carcinoma, and 11 (2.5%) cases of other types. According to International Federation of Gynecology and Obstetrics (FIGO) staging standard, 314 (71.4%) cases were at stage I and 126 (28.6%) cases were at stage II, respectively. The mean operation time was 221 (90-410) min and the average blood loss was 697 (80-2 300) mL. One hundred and forty eight patients received blood transfusion with an average volume of 825 (200-2 300) mL. 87 patients (19.8%) had lymph node metastasis, and the average number of positive lymph nodes was 2.1(1-5). 83 patients (18.9%) had lymph-vascular space involvement (LVSI). The patients stayed in hospital for 26(9-57) days. Post surgery complications occurred in 145 women (32.9%). They included urine retention, wound infection, lymphocyst, and deep-vein thrombosis (DVT). One hundred and 25 patients had more than 100 mL of post-void residual urine volume (PVR), and 73 patients got fever after surgery. Conclusions: Radical hysterectomy and pelvic lymphadenectomy performed in our hospital achieved better clinical outcome in the treatment of cervical cancer.