To explore the efficacy of domestic single-hole robotic surgery system in the treatment of pediatric urological diseases. A prospective review of clinical data of children who underwent laparoscopic surgery in the Department of Urology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, was conducted from July to November 2023. All surgeries were performed using the sharp single-port serpentine arm robotic surgery system, with an umbilical access route. All surgeries are performed by the same chief physician. Operative time, intraoperative blood loss, incision size, and postoperative complications were recorded. A total of 12 patients were included, consisting of 8 males and 4 females, aged 8.0-17.0 (13.5±2.7) years. The procedures included 5 pyeloplasties (1 case of bilateral pyeloplasty), with a unilateral operative time [M (Q1, Q3) ]of 180 (145, 200) minutes and a blood loss of 5 (5, 10) ml. Oral mucosa ureteroplasty was performed in 1 patient, taking 3 hours and 52 minutes with a blood loss of 10 ml. Renal cyst decortication was conducted in 1 case in 85 minutes with a blood loss of 20 ml. High ligation of the spermatic vein was conducted in 3 patients, with an average operative time of 97 minutes and no intraoperative blood loss. Bilateral gonadectomy was completed in 80 minutes with a blood loss of 5 ml. Ovarian cystectomy (1 case) was performed in 69 minutes with a blood loss of 5 ml. All surgeries were successfully completed without conversion to open surgery. Except for the oral mucosa ureteroplasty, which required an additional 5 mm auxiliary port, all procedures were performed through a 3 cm umbilical incision. Among the patients who underwent pyeloplasty, 1 case of urinary leak was identified and successfully treated conservatively with adequate drainage over 25 days. Re-stenosis was experienced by 1 patient with a long segment ureteral stricture postoperatively, while no Clavien-Dindo grade≥2 complications were observed in other patients. All umbilical wounds were concealed, and satisfactory postoperative appearances were noted. The domestic single-hole robotic surgery system is effective in treating pediatric urological diseases.
探讨国产单孔机器人手术系统治疗小儿泌尿外科疾病的疗效。前瞻性纳入2023年7至11月上海交通大学医学院附属上海儿童医学中心泌尿外科行腹腔镜手术治疗的患儿的临床资料。所有患儿均采用术锐单孔蛇形臂机器人手术操作系统进行，所有手术均采用经脐部腹腔入路，均由同一位医师操作，记录手术时间、术中出血量、切口大小以及术后并发症等。共纳入12例患儿，男8例，女4例，年龄8.0~17.0（13.5±2.7）岁。其中肾盂成形术5例（1例为双侧肾盂成形），单侧手术时间［M（Q1，Q3）］为180（145，200）min，出血量5（5，10）ml；口腔黏膜输尿管修补术1例，手术时间3 h 52 min，出血量10 ml。肾囊肿开窗术1例，手术时间85 min，出血量20 ml；精索静脉高位结扎术3例，平均手术时间97 min，术中无出血；双侧性腺切除术1例，手术时间80 min，出血量5 ml；卵巢囊肿剥离术1例，手术时间69 min，出血量5 ml。所有手术均顺利完成，无中转开放。除口腔黏膜输尿管修补术中增加1个5 mm辅助孔外，其他均为脐部3 cm单切口完成。行肾盂成形术的患儿中，术后有1例出现尿外瘘，经充分引流保守治疗25 d后治愈；1例输尿管长段狭窄的患儿术后出现再狭窄；其余患儿术后均未出现Clavien-Dindo≥2级并发症。所有患儿脐部伤口隐匿，术后外观满意。国产单孔机器人手术系统治疗小儿泌尿外科疾病疗效尚可。.