机器人手术已证明其结果与开腹和腹腔镜扩大胆囊切除术相当或优于开腹和腹腔镜手术。1-8 尽管微创机器人单端口 (SP) 系统具有优势，但由于仪器限制和回缩问题，在复杂的肝胆胰腺手术中仍未得到充分利用。 9,10 本研究评估了达芬奇 SP 系统在胆囊癌手术中的可行性、安全性和有效性。该研究得到了 OOO 大学医院伦理委员会的批准（IRB 号 DAUH IRB-24-081），并按照赫尔辛基宣言的原则进行。由于该研究采用回顾性设计，因此免除了知情同意的要求。一名 62 岁的女性被诊断患有胆囊癌，被转诊接受手术。术前计算机断层扫描 (CT) 扫描未显示转移证据 (T2N0)。因此，计划进行机器人 SP 扩大胆囊切除术。图 1 显示了为此过程插入的 30 毫米 SP 端口和 1 毫米辅助端口。由于缺乏用于肝楔形切除的能量装置，因此使用马里兰双极钳，模仿凯利钳挤压技术。使用单极烧灼钩对 7、8、12 和 13 站进行淋巴结切除（图 2）。图 1 使用达芬奇 Xi 系统进行机器人扩大胆囊切除术的端口放置 图 2 全淋巴结清扫演示 结果：手术总持续时间为 226 分钟，估计失血量为 200 毫升。第5天CT扫描未见异常，第7天患者正常出院（图3）。病理检查证实腺癌（T2a）已切除干净，所有六个淋巴结的恶性肿瘤检测均为阴性。图 3 手术后 2 周的伤口 结论：这项研究强调了机器人手术的充分性，并强调了达芬奇 SP 系统在肝胆手术中的潜力。尽管目前面临与仪器限制相关的挑战，但作者相信 SP 系统将在可预见的未来发展成为肝胆外科实践的重要资产。© 2024。外科肿瘤学会。

Robotic surgery has demonstrated outcomes comparable or superior to open and laparoscopic surgeries for extended cholecystectomy.1-8 Despite its advantages, the minimally invasive robotic single-port (SP) system remains underutilized in complex hepatobiliary pancreatic surgery due to instrument limitations and retraction issues.9,10 This study evaluated the feasibility, safety, and effectiveness of the da Vinci SP system in gallbladder cancer surgery. The study was approved by the Ethics Committee of OOO University Hospital (IRB no. DAUH IRB-24-081) and conducted in accordance with the principles of the Declaration of Helsinki. The requirement for informed consent was waived due to the study's retrospective design.A 62-year-old woman with a diagnosis of gallbladder cancer was referred for surgery. Preoperative computed tomography (CT) scans showed no evidence of metastasis (T2N0). Therefore, a robotic SP extended cholecystectomy was planned. Figure 1 shows a 30-mm SP port and a 1-mm assistant port inserted for the procedure. Due to the absence of an energy device for the liver wedge resection, Maryland bipolar forceps were used, mimicking the Kelly clamp crushing technique. A monopolar cautery hook was used for lymph node resection of stations 7, 8, 12, and 13 (Fig. 2). Fig. 1 Port placement for robotic extended cholecystectomy using the da Vinci Xi system Fig. 2 Demonstration of full lymph node dissection RESULTS: The total duration of the operation was 226 min, with an estimated blood loss of 200 ml. The CT scan on day 5 showed no abnormalities, and the patient was discharged routinely on day 7 (Fig. 3). The pathologic examination confirmed adenocarcinoma (T2a) with clear resection, and all six lymph nodes tested negative for malignancy. Fig. 3 The wound 2 weeks after surgery CONCLUSIONS: This study underscores the adequacy of robotic surgeries and emphasizes the potential of the da Vinci SP system in hepatobiliary surgery. Despite current challenges related to instrument limitations, the authors are confident that the SP system will evolve into a crucial asset for hepatobiliary surgical practices in the foreseeable future.© 2024. Society of Surgical Oncology.