单孔机器人辅助腹腔镜胆囊切开取石术的应用分析

Application analysis of single-port robot-assisted laparoscopic cholecystolithotomy

摘要:

目的 探讨单孔机器人辅助腹腔镜胆囊切开取石术治疗单发胆囊结石的可行性、安全性及近期疗效。方法 回顾性分析2025年1月－2025年6月于该院接受单孔机器人辅助腹腔镜胆囊切开取石术的50例单发胆囊结石患者的临床资料。记录手术相关情况、术后并发症和术后恢复情况。结果 所有患者均顺利完成手术，无中转多孔腹腔镜和开腹者。手术时间为25～66 min，平均（41.5±10.7）min；胆囊切口缝合时间为10～25 min，平均（16.0±4.0）min；术中出血量为3～15 mL，平均（7.0±2.9）mL；术后住院时间为2～5 d，平均（3.1±0.7）d。并发症发生率较低，为8.0%（4/50），包括：发热2例、切口轻度红肿2例，均为轻微并发症，经对症处理后痊愈，未发生严重并发症。脐部切口愈合良好，温哥华瘢痕量表（VSS）评分提示瘢痕质量良好，患者总体美容满意度高。术后4个月复查B超，无结石残留。结论 单孔机器人辅助腹腔镜胆囊切开取石术在严格选择适应证的前提下是安全、可行的，其操作灵活度高，缝合精确，美容效果佳，短期并发症少，为保胆取石治疗提供了新的选择。

Abstract:

Objective To evaluate the feasibility, safety, and short-term outcomes of single-port robot-assisted laparoscopic cholecystolithotomy for patients with solitary gallstones.Methods The clinical data of 50 patients with solitary gallstones who underwent single-port robot-assisted laparoscopic cholecystolithotomy from January 2025 to June 2025 in our hospital were retrospectively analyzed. Surgery-related conditions, postoperative complications, and postoperative recovery were recorded.Results All operations were completed successfully without conversion to multi-port laparoscopy or laparotomy. Operative time was 25 ~ 66 minutes, mean (41.5 ± 10.7) min; the time for suturing the gallbladder incision was 10 ~ 25 minutes, with an average of (16.0 ± 4.0) min; blood loss was 3 ~ 15 mL, mean (7.0 ± 2.9) mL. Postoperative hospital stay was 2 ~ 5 days, mean (3.1 ± 0.7) d. The incidence of complications was relatively low with 8.0% (4/50), all of which were minor. They included two cases of fever and two cases of mild redness and swelling at the incision site. All recovered after appropriate treatment and no serious complications occurred. The umbilical incision has healed well. The Vancouver Scar Scale (VSS) score indicated good scar quality, and the patient had a relatively high overall aesthetic satisfaction. Four months after the surgery, a follow-up ultrasound examination showed no residual stones.Conclusion Under the premise of strictly selecting indications, single-port robot-assisted laparoscopic cholecystolithotomy is safe and feasible. It features high operational flexibility, precise suturing, excellent cosmetic effect, and few short-term complications, providing a new option for gallbladder-preserving treatment.