CAPABILITIES OF THE SURGICAL ROBOTIZED COMPLEX IN ABDOMINAL SURGERY

A.V. FEDOROV, A.G. KRIGER, S.V. BERELAVICHUS, G.G. KARMAZANOVSKY, V.A. VISHNEVSKY, M.G.YEFANOV, D.S. GORIN, V.S. SHIROKOV, E.V. KONDRATYEV

Institute of Surgery named after Vishnevsky, Moscow, RUSSIA

The aim of the study: is to determine tactics and capabilities of robot-assisted interventions in patients with surgical diseases of the abdominal cavity and retroperitoneal space.

Materials and methods: Since March 2009 in the abdominal department of the institute of surgery named after Vishnevsky there were performed 74 operations with the application of a surgical robot “da Vinci”: 36 liver resections, 8 resections of the pancreas, 1 PRD, 29 operations on other organs of the abdominal and retroperitoneal space.

The algorithm of preoperative examination of patients included computer simulation of the upcoming surgery. Patients were performed computed tomography with 3D reconstruction. The zone of ​​surgical exposure, its area were determined, topography adjacent organs and structures was assessed, optimal points on the anterior abdominal wall for robotic and assistant ports were found.

Results: Interventions most adequate for the performance on a robot are the following: segmental resection of the liver (mainly segments VII and VIII), resection of the pancreas, spleen, the mobilization stage in the PRD, adrenalectomy, removal of NRT raging between 3 to 10 cm in diameter with a thick capsule, resection of rectum.

Conclusion: The use of robotic complex in all the above interventions allows provision of high-quality three-dimensional images, precision mobilization, reduction of intraoperative injury and blood loss, comfortable position of a surgeon during complex manipulations, which, in its turn, leads to improvement of capabilities of laparoscopic surgery.

Date: 2014-12-28; view: 1097