机器人协助泌尿外科手术中患者体位关联的损伤
作者：James T. Mills, Michael B. Burris, Daniel J. Warburton, Mark R. Conaway, et al. 来源：Journal of Urology 日期：2013-03-12
导读
Positioning Injuries Associated with Robotic-Assisted Urologic Surgery
Abstract
Introduction
Nerve injury associated with patient positioning during surgery is well-documented. With the development of robotic surgery, surgeons are faced with new surgical positioning, requiring attention to ensure patient safety. Published reports that address positioning injury during robotic surgery are sparse and none address the overall incidence. We sought to determine the incidence of positioning injury during robotic-assisted urologic surgery, identify risk factors, and describe the time to resolution of the neurologic injury.
Materials and Methods
We reviewed all adult urologic cases at our institution that utilized the da Vinci Si and da Vinci standard surgical system from January 2010 to December 2011. We characterized risk factors into four domains: positioning, operative, patient-specific, and anesthesia-related. Within these four categories, we collected 13 specific aspects of patient care to determine their association with positioning injury.
Results
Out of 334 operations, 22 positioning injuries (6.6%) were documented. Thirteen (59.1%) injuries resolved within one month, four (18.2%) resolved between one and six months, and five (22.7%) persisted beyond six months. We found operative time (p<0.0001), in-room time (p<0.0001), and ASA class (p=0.0033) were significantly associated with injury.
Conclusions
Positioning injuries are under-recognized in robotic-assisted urologic surgery and may persist beyond six months. Consideration must be given to counseling patients about the risks of positioning injuries, especially for long operations. Patients with multiple medical co-morbidities (ASA Class 4) are particularly at risk for these injuries.
http://www.jurology.com/article/S0022-5347(13)03461-7/abstract
分享：
相关文章
评论
我要跟帖发表
回复 小鸭梨：
发表
