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ID 116363
Title Alternative
男性のロボット支援回腸導管造設術において患者側外科医は重要な役割を果たす
Author
Sasaki, Yutaro Tokushima University
Fukuta, Kyotaro Tokushima Prefectural Central Hospital
Shiozaki, Keito Tokushima Prefectural Central Hospital
Ozaki, Keisuke Tokushima University
Ueno, Yoshiteru Tokushima University
Izaki, Hirofumi Tokushima Prefectural Central Hospital KAKEN Search Researchers
Kanda, Kazuya Tokushima Prefectural Central Hospital
Keywords
Minimally invasive surgery
Patient-side surgeon
Robot-assisted intracorporeal ileal conduit urinary diversion
Surgical technique
Content Type
Thesis or Dissertation
Description
The influence of the console surgeon on the feasibility and outcome of various robot-assisted surgeries has been evaluated. These variables may be partially affected by the skills of the patient-side surgeon (PSS), but this has not been evaluated using objective data. This study aimed to describe the surgical techniques of the PSS in robot-assisted radical cystectomy (RARC) and intracorporeal ileal conduit (ICIC) urinary diversion and objectively examine the changes in surgical outcomes with increasing PSS experience. During a 3-year period, 28 men underwent RARC and ICIC urinary diversion. Clinical characteristics and surgical outcomes were compared between patients who underwent surgery early (first half group) or late in the study period (second half group). The pre-docking incision enabled easy specimen removal. The glove port technique widened the working space of the PSS. The stay suture allowed the PSS to control the distal portion of the conduit, facilitating the passage of the ureteral stents. During stoma creation, pneumoperitoneum pressure was lost by opening the abdominal cavity. To overcome this problem, the robotic arm was used to lift the abdominal wall to maintain the surgical field and facilitate the PSS procedure. Compared with the first half group, the second half group had significantly shorter times for urinary diversion (202 min vs 148 min, p < 0.001), ileal isolation and anastomosis (73 min vs 45 min, p < 0.001), and stenting (23.0 min vs 6.5 min, p < 0.001). As the experience of the PSS increased, the time of the PSS procedures decreased.
Journal Title
Journal of Robotic Surgery
ISSN
18632491
Publisher
Springer Nature
Published Date
2021-06-03
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Yutaro Sasakiの学位論文として提出され,学位審査・授与の対象となっている。
Rights
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3537号
Diploma Number
甲医第1504号
Granted Date
2021-09-09
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
Medical Sciences
University Hospital