gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2023-22-4-89-98gnck-1845Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПервый опыт применения робот-ассистированной вентральной ректопексии сетчатым имплантом с использованием системы Senhance® в лечении пациентов с синдромом обструктивной дефекацииThe first experience of robot-assisted vental mesh rectopexy using the Senhance® system in the treatment of patients with obstructive defecation syndromehttps://orcid.org/0000-0002-2108-2362ХитарьянА. Г.KhitaryanA. G.

Хитарьян Александр Георгиевич — д.м.н., проф., зав. кафедрой хирургических болезней №3, пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

заведующий хирургическим отделением, ул. Варфоломеева, д. 92а, г. Ростов-на-Дону, 344011

Alexander G. Khitaryan, Nakhichevansky lane 29, Rostov-on-Don, 344022;

Varfolomeeva street, 92a, Rostovon-Don 344011

khitaryan@gmail.comhttps://orcid.org/0000-0001-5647-1192ГоловинаА. А.GolovinaA. A.

Головина Анастасия Андреевна — врач-хирург, пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;аспирант кафедры хирургических болезней № 3, ул. Варфоломеева, д. 92а, г. Ростов-на-Дону, 344011

Anastasiya A. Golovina, Nakhichevansky lane 29, Rostov-on-Don, 344022;

Varfolomeeva street, 92a, Rostovon-Don 344011

 

a_anastacia@icloud.comhttps://orcid.org/0000-0002-0078-260XВелиевК. С.VelievK. S.

Велиев Камиль Савинович — врач-хирург, пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

ул. Варфоломеева, д. 92а, г. Ростов-на-Дону, 344011

Kamil S. Veliev, Nakhichevansky lane 29, Rostov-on-Don, 344022;

Varfolomeeva street, 92a, Rostovon-Don 344011

 

koma.81@yandex.ruhttps://orcid.org/0000-0001-7787-4919МежунцА. В.MezhuntsA. V.

Межунц Арут Ваграмович — к.м.н., врач-хирург, пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

ассистент кафедры хирургических болезней №3, ул. Варфоломеева, д. 92а, г. Ростов-на-Дону, 344011

Arut V. Mezhunts, Nakhichevansky lane 29, Rostov-on-Don, 344022;

Varfolomeeva street, 92a, Rostovon-Don 344011

arut.mezhunts@mail.ruhttps://orcid.org/0000-0003-4724-3774АлибековА. З.AlibekovA. Z.

Алибеков Альберт Заурбекович - к.м.н., доцент кафедры хирургических болезней №3, пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

ул. Варфоломеева, д. 92а, г. Ростов-на-Дону, 344011

Albert Z. Alibekov, Nakhichevansky lane 29, Rostov-on-Don, 344022;

Varfolomeeva street, 92a, Rostovon-Don 344011

 

xupypr@doctor.comhttps://orcid.org/0000-0002-9508-5179ОреховА. А.OrekhovA. A.

Орехов Алексей Анатольевич — к.м.н., доцент кафедры хирургических болезней №3, пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

врач-хирург, ул. Варфоломеева, д. 92а, г. Ростов-на-Дону, 344011

Alexey A. Orekhov, Nakhichevansky lane 29, Rostov-on-Don, 344022;

Varfolomeeva street, 92a, Rostovon-Don 344011

amputation3@mail.ruХитарьянВ. А.KhitaryanV. A.

Хитарьян Вера Александровна - студент,

пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

Vera A. Khitaryan, Nakhichevansky lane 29, Rostov-on-Don, 344022

 

veralyapina02@gmail.comhttps://orcid.org/0000-0001-5632-1469ОплимахК. С.OplimahK. S.

Оплимах Ксения Сергеевна - ординатор кафедры хирургических болезней № 3,

пер. Нахичеванский, д. 29, г. Ростов-на-Дону, 344022;

Kseniya S. Oplimah, 

Nakhichevansky lane 29, Rostov-on-Don, 344022

 

net.2035@mail.ruФГБОУ ВО «Ростовский государственный медицинский университет», кафедра хирургических болезней № 3; ЧУЗ «Клиническая больница «РЖД-Медицина»РоссияRostov State Medical University, Department of Surgical Diseases №3; Private Healthcare Institution “Clinical Hospital” Russian Railways-Medicine”Russian FederationФГБОУ ВО «Ростовский государственный медицинский университет», кафедра хирургических болезней № 3РоссияRostov State Medical University, Department of Surgical Diseases №3Russian Federation2023211220232248998Copyright © Хитарьян А.Г., Головина А.А., Велиев К.С., Межунц А.В., Алибеков А.З., Орехов А.А., Хитарьян В.А., Оплимах К.С., 20232023Хитарьян А.Г., Головина А.А., Велиев К.С., Межунц А.В., Алибеков А.З., Орехов А.А., Хитарьян В.А., Оплимах К.С.Khitaryan A.G., Golovina A.A., Veliev K.S., Mezhunts A.V., Alibekov A.Z., Orekhov A.A., Khitaryan V.A., Oplimah K.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1845Цель исследования

Цель исследования: изучение начальных результатов применения робот-ассистированной вентральной ректопексии сетчатым имплантом с использованием новой системы Senhance в лечении пациентов с синдромом обструктивной дефекации.

Пациенты и методы

Пациенты и методы: в проспективное когортное исследование включались пациенты, которым проводилось хирургическое лечение синдрома обструктивной дефекации, обусловленного наличием ректоцеле и/или выпадения и/или внутренней инвагинации прямой кишки при помощи робот-ассистированной вентральной ректопексии сетчатым имплантом с использованием системы цифровой лапароскопии Senhance®. Проводился анализ оптимальной расстановки троакаров и расположения роботических рук, оценка продолжительности вмешательства, объема интраоперационной кровопотери. В послеоперационном периоде изучали число рецидивов, число осложнений и степень их тяжести по шкале Clavien-Dindo, выраженность болевого синдрома по ВАШ.

Результаты

Результаты: в исследование были включены 22 пациента. Средняя длительность оперативного вмешательства составила 87,1 ± 24,3 мин. Объем интраоперационной кровопотери составил 19,8 ± 9,6 мл. Конверсии на открытый или лапароскопический доступы не было. Осложнений оперативного лечения не наблюдалось. Болевой синдром на 1 сутки составил, в среднем, 22,5 мм по ВАШ. При контрольном осмотре анатомического рецидива среди пациентов выявлено не было, медиана периода наблюдения составила 20,4 месяцев (7–22 мес.).

Выводы

Выводы: выполнение робот-ассистированной вентральной ректопексии с использованием системы Senhance® эффективно и безопасно для пациента. Непосредственные результаты применения роботического доступа сопоставимы с лапароскопическим. Однако использование системы цифровой лапароскопии Senhance® является экономически целесообразным в сравнении с другими роботическими системами.

Aim

Aim: to assess primary results of robot-assisted ventral mesh procedure using the new Senhance® robotic system for obstructive defecation syndrome.

Patients and Methods

Patients and Methods: the prospective cohort study included patients who underwent robot-assisted ventral mesh rectopexy with the Senhance® system for obstructive defecation syndrome caused by rectocele and/or rectal prolapse and/or internal intussusception. The optimal trocar sites, the location of robotic arms, operation time and intraoperative blood loss were evaluated, as well as post-op morbidity rate (Clavien-Dindo scale), pain intensity (VAS scale) and recurrence rate.

Results

Results: the study included 22 patients. Operation time was 87.1 ± 24.3 minutes. The intraoperative blood loss was 19.8 ± 9.6 ml. No conversion to open or laparoscopic approach occurred, no morbidity occurred. Pain intensity on day 1 was 0.255 mm according to VAS. No anatomical recurrence was revealed. The median follow-up period was 20.4 months (7–22 months).

Conclusion

Conclusion: robotic-assisted ventral rectopexy using the Senhance® system is effective and safe. The results are similar to laparoscopic ones. However, the use of the Senhance® system is cost effective compared to other robotic systems.

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The authors declare that there are no conflicts of interest present.