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da Vinci SP system을 이용한 단일공 로봇 신우성형술과 기존의 다중포트를 이용한 로봇 신우성형술의 소아환자의 outcome 비교 |
¹국민건강보험공단 일산병원
²연세의대 신촌세브란스병원 |
| 강숭구¹, 장원식², 김성훈², 김상운², 한상원², 이용승² |
Purpose
We compared the intraoperative/postoperative outcomes of robot-assisted laparoscopic single-port pyeloplasty using the da Vinci SP® system and the conventional robot assisted laparoscopic multi-port pyeloplasty in pediatric patients. Additionally, we investigated the feasibility and learning curve of pyeloplasty in pediatric patients using the da Vinci SP® system.
Materials and Methods
Multi-port and single-port pyeloplasty have been performed in pediatric patients in our institution since October 2015 and February 2019, respectively. We did an entire cohort comparison. Considering the learning curve of multi-port pyeloplasty, a subgroup analysis was performed. We also performed a learning curve analysis through operation time of robot-assisted laparoscopic single-port pyeloplasty using the da Vinci SP® system.
Results
Thirty-one patients who underwent multiport pyeloplasty and ten patients who underwent single port pyeloplasty were enrolled. Median operative times were 3.0 (IQR: 2.5-3.6) and 2.4 (IQR: 2.3-2.9) and median console times were 2.2 (IQR: 1.7-2.7) and 1.5 (IQR: 1.4-1.7) hours for multi-port and single-port pyeloplasty, respectively (p=0.002). The median operative and console times for the 10 most recent cases of multi-port pyeloplasty were 2.5 and 1.7 hours when the single-port pyeloplasty group and the subgroup were compared (p=0.58 and p=0.44 for operative and console times, respectively). S-RALP learning curve analysis shows that stable performance can be expected starting with the 7th case (p<0.001).
Conclusions
This study confirmed that pyeloplasty using the da Vinci® SP system can be started by robotic surgeons who can overcome the learning curve. Robot-assisted laparoscopic single-port pyeloplasty was feasible in non-infant pediatric patients. After approximately 6 cases, relatively stable performance is possible.
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keywords : Robotic surgery, single port, pyeloplasty, pediatrics |
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