【摘 要】
：
Robotic use in general and urological surgery is becoming more widespread.The advantages of robot use may include not only the advantages usually associated with minimally invasive surgery but also in
【机 构】
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University of Pennsylvania USA
【出 处】
：
BIT`s 3rd Annual World Congress of NeuroTalk-2012(2012第三届国际神
论文部分内容阅读
Robotic use in general and urological surgery is becoming more widespread.The advantages of robot use may include not only the advantages usually associated with minimally invasive surgery but also increased surgical visualization, greater ability to perforrm micro-dissection, and improved cosmetics and wound healing.Anterior (trans abdominal or retroperitoneal) surgical approaches are routinely used for discectomy, interbody fusion, tumor resection and total disc arthroplasty.Typically, these approaches include a large anterior abdominal incision and manual retraction of the abdominal contents and vasculature.This may lead to a prolonged peri-operative recovery.In light of the minimallyinvasive nature of robotic use, we were interested in assessing its potential application in anterior spine surgical approaches to the lumbar spine.We chose the daVinci system because of its availablilty, familiarity of use, and utility in soft-tissue dissection.11 patients underwent robotic-assisted anterior lumbar interbody fusion (R-ALIF) at either the L4-5 or L5-S1 levels or both.These surgeries were performed for fusion for treatment of lower back pain due to degenerative disc disease.In all patients, a lithotomy position with Trendelenberg positioning.4-6 ports were placed and the abdomen was insufflated.The robotic arms were utilized for laproscopic dissection, exposure of the anterior disc space and retraction.A single interbody spacer was placed endoscopically under fluoroscopic guidance.The abdomen was closed and the patient was rolled into a prone position for posterior fusion.All patients demonstrated radiographic evidence of fusion.There were no specific complications related to the robot use.There was no time savings with robot use.Blood loss was minimal.Patient outcomes and hospitalizations were similar to standard approaches.In summary, R-ALIF is a feasible and safe minimally-invasive procedure.It is associated with a significant learning curve and outcomes have not yet proven superior to open procedures.
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