经口入路机器人手术在耳鼻咽喉头颈外科中的应用

Application of transoral robotic surgery in otolaryngologyhead and neck surgery

摘要:

摘要：目的总结经口入路机器人手术（transoral robotic surgery，TORS）在耳鼻咽喉头颈外科应用的临床经验。方法2010年11月~2015年7月南京军区南京总医院耳鼻咽喉科应用“达芬奇”机器人手术系统对10例咽喉部病变患者行TORS, 回顾性分析患者临床资料，总结手术体会。结果10例患者均顺利完成手术。术野暴露平均用时34 min（20～60 min），调整开口器次数2~5次，平均手术时间为67 min（30～130 min）。患者平均住院时间为8 d（6～14 d），恢复经口进食平均需要5 d（2～10 d），出院时均可经口进食。术中及术后均未出现并发症。恶性肿瘤患者的术后病理学检查示切缘均未见癌细胞残留。结论在掌握好适应证的前提下，应用“达芬奇”机器人手术系统可以独立完成多种类型耳鼻咽喉头颈外科手术，其手术创伤小，患者术后恢复快，有着巨大的临床应用价值。

关键词:“达芬奇”机器人手术系统| 经口入路机器人手术|微创外科|耳鼻咽喉头颈外科

Abstract:

Abstract:ObjectiveTo summarize clinical experience on application of transoral robotic surgery (TORS) in otolaryngologyhead and neck surgery.MethodsFrom Nov 2010 to July 2015, 10 patients underwent TORS with da Vinci surgical system in our department. Their clinical data were analyzed retrospectively. The experience on TORS was summarized.ResultsTORS was accomplished successfully in all 10 patients. The surgical fieldexposed time ranged from 20 to 60 minutes with an average of 34.The operative time ranged from 30 to 130 minutes with an average of 67. The hospital stays ranged from 6 to 14 days with an average of 8, and recovery time for oral intake ranged from 2 to 10 days with an average of 10. All patients could take food orally before hospital discharge. During TORS, the mouth gag needed to be adjusted 2 to 5 times. No complications occurred during or after operation. Postoperative pathological examination of incisal edge in patients with malignant tumor showed no residual of tumor cell.ConclusionOn the premise of proper surgical indications, TORS, due to advantages of minimal invasion and rapid recovery, possesses enormous use value to the application in otolaryngologyhead and neck surgery.

Key words:da Vinci surgical system|TORS|Minimally invasive surgery| Otolaryngologyhead and neck surgery