演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

ロボット支援下胃癌手術におけるチームビルディングと手術成績

演題番号 : P9-5

[筆頭演者]
演者)平松 良浩:1,2 
[共同演者]
菊池 寛利:1、廣津 周:1、川田 三四郎:1、村上 智洋:1、松本 知拓:1、尾崎 裕介:1、森田 剛文:1、神谷 欣志:1、坂口 孝宣:1、今野 弘之:3、竹内 裕也:1

1:浜松医科大学・第二外科、2:浜松医科大学・周術期等生活機能支援学、3:浜松医科大学

 

[Background] Robot-assisted surgery using da Vinci Surgical System(DVSS) is thought to have many advantages over conventional laparoscopic surgery. It was reported that the use of the surgical robot might reduce surgery-related complications. This study evaluated the safety of RG using DVSS Xi.
[Methods] This single-center, prospective phase II study included patients with resectable gastric cancer (UMIN000019366). The primary endpoint was the incidence of post-operative complications greater than Grade III according to Clavien-Dindo classification during one month after surgery. The secondary endpoints included all adverse events and completion rate of robotic surgery. In introducing RG, we constructed a da Vinci surgical team consisting of surgeons, anesthesiologists, nurses and clinical engineers, and visited plural proctor's institution to observe robotic gastrectomy as a team. Then, we held preoperative and postoperative conferences in all cases.
[Results]From Oct 2015 to Nov 2017, 24 patients were enrolled for this study. Distal gastrectomy were performed in 16 patients and total gastrectomy were performed in 8 cases. The incidence of post-operative complication greater than grade III was 0%. The overall incidence of adverse events was 20.8% (grade I; 16.7%, grade II; 4.1%). No patient required conversion to laparoscopic or open surgery; thus, the RG completion rate was 100%.
[Discussion] The observations of robotic operation as a team and team conferences in all cases were very useful for the standardization of operation procedure and the information sharing in the team. The medical team building might contribute to the evasion of the trouble during operation and to the favorable introduction of robotic surgery.
[Conclusion] This study suggested the introduction of RG seems to be safe and feasible by making a medical team about robotic surgery.

キーワード

臓器別:胃・十二指腸

手法別:内視鏡手術

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