• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of robotic surgery >Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis
【24h】

Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis

机译：猪模型中的机器人肾自聚体持续性：一种用于模拟机器人体内血管吻合术的方法特定培训平台

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency. This paper describes the requirements and steps developed for the above training purpose. Over a series of four animal ethics’ approved experiments, the technique of robotic-assisted laparoscopic autotransplantation of the kidney was developed in Amsterdam live pigs (60–70?kg). The surgery was based around the vascular anastomosis technique described by Menon et al. This non-survival porcine training model is targeted at transplant surgeons with robotic surgery experience. Under general anesthesia, each pig was placed in lateral decubitus position with the placement of one robotic camera port, two robotic 8?mm ports and one assistant port. Robotic docking over the pig posteriorly was performed. The training platform involved the following procedural steps. First, ipsilateral iliac vessel dissection was performed. Second, robotic-assisted laparoscopic donor nephrectomy was performed with in situ perfusion of the kidney with cold Hartmann’s solution prior to complete division of the hilar vessels, ureter and kidney mobilization. Thirdly, the kidney was either kept in situ for orthotopic autotransplantation or mobilized to the pelvis and orientated for the vascular anastomosis, which was performed end to end or end to side after vessel loop clamping of the iliac vessels, respectively, using 6/0 Gore-Tex sutures. Following autotransplantation and release of vessel loops, perfusion of the graft was assessed using intraoperative indocyanine green imaging and monitoring urine output after unclamping. This training platform demonstrates adequate face and content validity. With practice, arterial anastomotic time could be improved, showing its construct validity. This porcine training model can be useful in providing training for robotic intracorporeal vascular anastomosis and may facilitate confident translation into a transplant human recipient.
机译：最近已经开发出达芬奇（直观，美国）平台的机器人辅助肾移植（RKT）通过降低手术部位并发症和发病率，特别是在肥胖患者中提高结果。这种潜在的肾移植手术技术的范式转移仅在几个中心中进行。为了更广泛地采用这种高利益复杂的操作，我们旨在在猪模型中开发一种程序特异性模拟平台，用于培训机器人体内血管吻合术和评估血管吻合术的通风。本文介绍了以上述培训目的开发的要求和步骤。在一系列四种动物伦理的批准实验中，在阿姆斯特丹活猪（60-70？kg）中开发了肾脏的机器人辅助腹腔镜自聚体持续技术。手术基于Menon等人描述的血管吻合术技术。这种非生存猪训练模型是针对具有机器人外科经验的移植外科医生。在全身麻醉下，将每只猪放在横向褥疮位置，并在一个机器人相机端口，两个机器人8？MM端口和一个助理端口处于侧向褥疮位置。进行后切换猪的机器人对接。培训平台涉及以下程序步骤。首先，进行同侧髂血管夹层。其次，在完全灌注肝脏血管，输尿管和肾动员之前，用肾脏灌注进行肾脏灌注的腹腔镜供体肾切除术。第三，肾脏以原位为原位，用于原位的自聚体，或者动员到骨盆，并定向血管吻合术，分别使用6/0血管的血管环夹持髂血管的血管环夹持后的末端或末端。 -tex缝合线。在对容器环的自聚体持续和释放之后，使用术中吲哚菁绿色成像和监测尿液输出在松开后进行灌注。该培训平台展示了足够的面部和内容有效性。通过实践，可以提高动脉吻合时间，显示其构建有效性。该猪训练模型可用于为机器人体内血管吻合术提供培训，可以促进自信地翻译成移植人类受体。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号