Robotic surgery for congenital biliary dilatation using the scope switch technique (with video)
Robotic surgery for congenital biliary dilatation using the scope switch technique (with video)
复制标题
使用内窥镜切换技术进行先天性胆道扩张症的机器人手术（附视频）
DOI：
10.1016/j.asjsur.2023.02.021
复制
发表时间：
2023
影响因子：
3.5
通讯作者：
Fujiwara Toshiyoshi
中科院分区：
文献类型：
--
作者：
Takagi Kosei;Umeda Yuzo;Yoshida Ryuichi;Fuji Tomokazu;Yasui Kazuya;Yagi Takahito;Fujiwara Toshiyoshi
技术微创先天性胆管扩张术（CBD）技术要求高。然而，很少有研究报道机器人手术治疗CBD的手术方法。本报告介绍了使用范围开关技术的机器人CBD手术。我们的CBD机器人手术技术包括四个步骤：第一步，Kocher操作;第二步，使用范围切换技术解剖肝十二指肠韧带;第三步，准备Roux-en-Y环;结果内镜切换技术可提供不同的胆道解剖入路，包括通过标准位置的前入路和通过镜开关位置的右入路。当接近胆管腹侧和左侧时，宜采用标准体位的前入路。相反，内窥镜开关位置的侧视图更适合从侧面和背侧接近胆管。使用这种技术，扩张的胆管可以从四个方向周向分离：前，内，外，后。此后，完全切除的胆总管囊肿可以achieved.ConclusionsThe范围开关技术在机器人手术的CBD可以是有用的解剖周围的胆管与不同的手术视图，导致完全切除的胆总管囊肿。
TechniqueMinimally invasive congenital biliary dilatation (CBD) surgery is technically demanding. However, few studies have reported surgical approaches of robotic surgery for CBD. This report presents robotic CBD surgery using a scope-switch technique. Our robotic surgery technique for CBD consisted of four steps: step 1, Kocher's maneuver; step 2, dissection of the hepatoduodenal ligament using the scope switch technique; step 3, preparation for the Roux-en-Y loop; and step 4, hepaticojejunostomy.ResultsThe scope switch technique can provide different surgical approaches for dissecting the bile duct, including anterior approach by the standard position and right approach by the scope switch position. When approaching the ventral and left side of the bile duct, anterior approach with the standard position is suitable. In contrast, the lateral view by the scope switch position is preferable for approaching the bile duct laterally and dorsally. Using this technique, the dilated bile duct can be dissected circumferentially from four directions: anterior, medial, lateral, and posterior. Thereafter, complete resection of the choledochal cyst can be achieved.ConclusionsThe scope switch technique in robotic surgery for CBD can be useful for dissecting around the bile duct with different surgical views, leading to the complete resection of the choledochal cyst.