Background

The study objective was to evaluate combined endoscopic and robotic surgery, a novel surgical technique modifying traditional combined endoscopic laparoscopic surgery through robotic assistance, and characterize a series of patients who underwent the modified operative technique.

Methods

A retrospective case series was performed. The first thirty-seven consecutive patients who underwent combined endoscopic robotic surgery by a single colorectal surgeon from March 2018 to October 2019 were included. Main outcome measures included operative time, intra-operative complication, 30-day post-operative complication, and hospital length of stay.

Results

Combined endoscopic and robotic surgery was performed in 37 cases, 32 (86.5%) of which saw the technique through to completion. Median operative room time was 73 min (range 31–184 min). No intraoperative complications occurred and 2 (6.3%) experienced 30-day post-operative complications. Median hospital length of stay was 1.1 days (range 0.2–2.0 days). Median polyp size was 35 mm (range 20–130 mm). Polyps were resected from the following locations: cecum (37.5%), ascending colon (28.1%), transverse colon (21.9%), descending colon (3.1%), sigmoid colon (6.3%), and rectum (3.1%). Pathology demonstrated 77.4% tubular adenoma, 12.9% sessile serrated adenoma, 6.5% dysplasia, and 3.2% signet cell adenocarcinoma.

Conclusion

Combined endoscopic robotic surgery was associated with decreased operative time, complication rates, and hospital length of stay compared to literature-reported statistics for combined endoscopic laparoscopic surgery. Increased confidence with 3-dimensional visualization and intracorporeal suturing using combined endoscopic and robotic surgery was noted. Additional studies are needed to further define the role of robotics in combined endoscopic surgery.

中文翻译：

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复杂结肠息肉切除联合内窥镜机器人手术：病例系列

背景

研究目的是评估联合内窥镜和机器人手术，这是一种通过机器人辅助修改传统联合内窥镜腹腔镜手术的新型手术技术，并描述一系列接受改良手术技术的患者。

方法

进行了回顾性病例系列研究。纳入了 2018 年 3 月至 2019 年 10 月期间由一名结直肠外科医生进行联合内窥镜机器人手术的前 37 名连续患者。主要结果指标包括手术时间、术中并发症、术后 30 天并发症和住院时间。

结果

37 例患者进行了内窥镜和机器人联合手术，其中 32 例 (86.5%) 完成了该技术。中位手术室时间为 73 分钟（范围 31-184 分钟）。没有发生术中并发症，2 例 (6.3%) 出现术后 30 天并发症。中位住院时间为 1.1 天（范围 0.2-2.0 天）。中位息肉大小为 35 毫米（范围 20-130 毫米）。从以下位置切除息肉：盲肠 (37.5%)、升结肠 (28.1%)、横结肠 (21.9%)、降结肠 (3.1%)、乙状结肠 (6.3%) 和直肠 (3.1%)。病理显示 77.4% 为管状腺瘤，12.9% 为无蒂锯齿状腺瘤，6.5% 为异型增生，3.2% 为印戒细胞腺癌。

结论

与文献报道的联合内窥镜腹腔镜手术统计数据相比，联合内窥镜机器人手术与手术时间、并发症发生率和住院时间的减少相关。注意到使用联合内窥镜和机器人手术的 3 维可视化和体内缝合增加了信心。需要更多的研究来进一步确定机器人技术在联合内窥镜手术中的作用。