康多手术机器人辅助腹腔镜膀胱平滑肌瘤黏膜外切除术1例报告

Robot-assisted laparoscopic extramucosal resection of bladder leiomyoma with KangDuo Surgical System: a case report

摘要

目的 探讨康多手术机器人辅助腹腔镜膀胱平滑肌瘤黏膜外切除术的可行性和安全性。病例报告 患者女，41岁，因体检发现膀胱左侧壁占位入院。无尿频、尿急、排尿困难及血尿等症状。术前超声及增强计算机断层扫描（CT）提示膀胱左侧壁边界清楚的软组织肿物，膀胱镜检查示肿物突入膀胱腔，表面黏膜光滑完整，双侧输尿管口未受累，术前考虑膀胱平滑肌瘤可能性大。患者接受康多手术机器人辅助腹腔镜膀胱肿瘤黏膜外切除术。术中沿肿瘤包膜于膀胱黏膜外完整切除肿瘤，并在确认膀胱黏膜完整后缝合重建膀胱壁。手术顺利完成，手术时间43 min，术中出血量极少，未留置盆腔引流管。患者术后恢复顺利，于术后第3天出院。术后病理证实为膀胱良性平滑肌瘤。规律随访1年，未见膀胱破裂等并发症发生，未观察到肿瘤复发。结论 对于表面黏膜完整、边界清楚且术前倾向良性的膀胱平滑肌瘤，机器人辅助腹腔镜黏膜外切除术具有良好的可行性和安全性，可在完整切除肿瘤的同时尽可能保留膀胱黏膜完整性和膀胱壁强度。康多手术机器人在精细分离及缝合重建过程中展现出良好的应用潜力，可为此类精细微创手术提供有效的设备支持。

Abstract

Objective To evaluate the feasibility and safety of KangDuo surgical robot-assisted laparoscopic extramucosal excision for bladder leiomyoma. Case report A 41-year-old woman was admitted after an incidental finding of a mass in the left lateral bladder wall during a routine physical examination. She had no urinary frequency, urgency, dysuria, hematuria, or other urinary symptoms. Preoperative ultrasonography and contrast-enhanced computed tomography (CT) revealed a well-defined soft-tissue mass in the left lateral bladder wall. Cystoscopy showed a mass protruding into the bladder cavity with intact and smooth overlying mucosa, without involvement of either ureteral orifice. Bladder leiomyoma was suspected. The patient underwent KangDuo surgical robot-assisted laparoscopic extramucosal resection of the bladder tumor. The tumor was completely dissected along its capsule outside the bladder mucosa, and the bladder wall was reconstructed after mucosal integrity was confirmed. The procedure was completed successfully, with an operation time of 43 min and minimal blood loss. No pelvic drainage tube was placed. The patient recovered uneventfully and was discharged on postoperative day 3. Postoperative pathology confirmed benign bladder leiomyoma. During 1 year of regular follow-up, no complications, including bladder rupture, or tumor recurrence were observed. Conclusion For bladder leiomyoma with intact overlying mucosa, clear boundaries, and benign preoperative features, robot-assisted laparoscopic extramucosal resection is a feasible and safe surgical option, which allows complete tumor removal while preserving mucosal integrity and bladder wall strength as much as possible. The KangDuo surgical system may facilitate precise dissection, suturing, and reconstruction in such delicate minimally invasive procedures.

关键词

膀胱平滑肌瘤 / 手术机器人 / 康多手术机器人 / 黏膜外切除

Key words

bladder leiomyoma / robot-assisted laparoscopic surgery / KangDuo surgical system / extramucosal resection

参考文献

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基金资助

国家重点研发计划项目(2023YFC2413400)