BACKGROUND To investigate the surgical methods and clinical results of robot-assisted laparoscopic antegrade inguinal lymphadenectomy. METHODS A retrospective study was performed on clinical data from 19 patients with penile cancer admitted from March 2013 to October 2017. Among them, nine patients underwent robot-assisted laparoscopic antegrade inguinal lymphadenectomy (robot-assisted group) and 10 patients underwent open inguinal lymphadenectomy (open group). In the robot-assisted group, preoperative preparation, patient position, robot placement, design of operating channel and establishment of operating space are described. Key surgical procedures and techniques are also summarized. In addition, the number of lymph nodes removed, postoperative complications and follow-up in both groups were statistically analyzed. RESULTS For the 9 patients in the robot-assisted group, surgery was successfully accomplished at 17 sides without intraoperative conversion to open surgery. The surgery time for each side was 45~90 min using laparoscope with an average of 68.5 ± 13.69 min/side. The intraoperative blood loss was estimated to be < 10 ml/side, and the number of removed lymph nodes was not significantly different from that of the open group (12 ± 4.2/side vs.11 ± 5.8/side, P = 0.84). There were no postoperative complications such as skin necrosis, delayed wound healing and cellulitis in the robot-assisted group. Skin-related complications occurred in 9 (45%) of the 20 sides in the open group. During a median follow-up of 25 months in robot-assisted group and 52.5 mouths in open group, was not significantly different there were no statistical differences in recurrence-free survival between the groups (75% vs 60%, p = 0.536). CONCLUSION Robot-assisted laparoscopic antegrade inguinal lymphadenectomy achieved the desired surgical outcomes with fewer intraoperative and postoperative complications. The robotic arms of the surgical system were placed between the lower limbs of each patient. There was no need to re-position the robotic arms during bilateral inguinal lymphadenectomy. This simplified the procedure and reduced the use of trocars. If necessary, pelvic lymphadenectomy could be performed simultaneously using the original trocar position.

中文翻译：

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机器人辅助腹腔镜顺行与腹股沟腹股沟淋巴结清扫术：一项回顾性对照研究。

背景技术探讨机器人辅助腹腔镜顺行腹股沟淋巴结清扫术的手术方法和临床效果。方法对2013年3月至2017年10月收治的19例阴茎癌患者的临床资料进行回顾性研究。其中9例行腹腔镜顺行腹股沟淋巴结清扫术（机器人辅助组），另10例行腹股沟开放性腹股沟淋巴结清扫术（机器人辅助组）。公开组）。在机器人辅助组中，描述了术前准备，患者位置，机器人放置，手术通道设计和手术空间的建立。还总结了关键的手术程序和技术。此外，对两组的淋巴结清除数量，术后并发症和随访情况进行了统计分析。结果对于机器人辅助组中的9例患者，成功地在17侧完成了手术，而没有术中转换为开放手术。腹腔镜每侧手术时间为45〜90 min，平均每侧68.5±13.69 min。术中失血量估计为<10 ml /侧，切除的淋巴结数目与开放组无明显差异（12±4.2 /侧vs. 11±5.8 /侧，P = 0.84）。机器人辅助组没有术后并发症，如皮肤坏死，伤口愈合延迟和蜂窝织炎。在开放组中，与皮肤相关的并发症发生在20侧中的9侧（45％）。在机器人辅助组中进行了25个月的中位随访，在开放组中进行了52.5口的中位随访，两组间无复发生存率无统计学差异（75％vs 60％，p = 0.536）。结论机器人辅助腹腔镜顺行腹股沟腹股沟淋巴结清扫术取得了理想的手术效果，术中和术后并发症更少。手术系统的机械臂放置在每个患者的下肢之间。在双侧腹股沟腹股沟淋巴结清扫术期间无需重新定位机械臂。这简化了程序并减少了套管针的使用。如有必要，可以使用原始的套管针位置同时进行盆腔淋巴结清扫术。结论机器人辅助腹腔镜顺行腹股沟腹股沟淋巴结清扫术取得了理想的手术效果，术中和术后并发症更少。手术系统的机械臂放置在每个患者的下肢之间。在双侧腹股沟腹股沟淋巴结清扫术期间无需重新定位机械臂。这简化了程序并减少了套管针的使用。如有必要，可以使用原始的套管针位置同时进行盆腔淋巴结清扫术。结论机器人辅助腹腔镜顺行腹股沟腹股沟淋巴结清扫术取得了理想的手术效果，术中和术后并发症更少。手术系统的机械臂放置在每个患者的下肢之间。在双侧腹股沟腹股沟淋巴结清扫术期间无需重新定位机械臂。这简化了程序并减少了套管针的使用。如有必要，可以使用原始的套管针位置同时进行盆腔淋巴结清扫术。