RESUMEN
Objective: To investigate the feasibility of transumbilical single-incision plus one port (SIPOP) robotic total mesorectal excision. Methods: Clinical data of a 70-year-old male patient with BMI 22.1 kg/m(2) who successfully underwent transumbilical single-incision plus 1 port robotic total mesorectal resection of upper rectal cancer at the General Surgery Department of Daping Hospital of Army Military Medical University on September 18, 2019 were retrospectively analyzed. Preoperative colonoscopy revealed that the distance of upper rectal cancer to anal edge was 14 cm, and the tumor size was 2.5 cm×1.5 cm×1 cm. Pathological result confirmed rectal moderately differentiated adenocarcinoma. The preoperative abdominal CT showed thickened bowel-wall of upper rectum and the blurred perirectal fat, suggesting tumor infiltration. Results: The operation was successful. There were no conversion to laparotomy or abdominal auxiliary incision, and the mesorectum of the specimen was intact. The operation time was 165 minutes, the blood loss was about 20 ml, and there were no complications such as injury to peripheral organs. Postoperative pathology showed ulcerative moderately differentiated adenocarcinoma of the upper rectum with TNM stage IVA (T4N2b). The postoperative recovery was smooth. Patient ambulated on the 1st day, the catheter was removed on the 7th day, and discharged from the hospital on the 8th day. Conclusion: The transumbilical SIPOP robotic total mesorectal excision is safe, effective and feasible.
Asunto(s)
Laparoscopía , Neoplasias del Recto , Procedimientos Quirúrgicos Robotizados , Robótica , Anciano , Humanos , Masculino , Neoplasias del Recto/cirugía , Recto , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Robotic-assisted transanal total mesorectal excision (R-TaTME) has unique advantage in low rectal cancer. Single incision plus oneport (SIPOP) laparoscopic operation can synchronously cooperate with robotic-assisted transanal operation, in order to the difficulty of operation, improve the quality of operation and shorten the time of operation. A retrospective analysis was conducted on the clinical and pathological data of one patient who underwent SIPOP synchronously combined with R-TaTME + sigmoid-anal anastomosis + ileostomy at the Department of General Surgery, Army Characteristic Medical Center on September 11, 2019. This 71-year-old patient was male with body mass index of 24.08 kg/m(2) and received preoperative chemotherapy. Rectal adenocarcinoma was confirmed by colonoscopy biopsy, and distance from tumor lower edge to anal verge was 3 cm. MRI indicated T2N1 stage. The operation was completed successfully, and the transabdominal and robotic transanal surgery totaled 117 minutes, with 15 minutes for the robotic transanal preparation step. There was about 20 ml of intraoperative blood loss and no blood transfusion was performed. The patient was discharged 6 days after operation. No intraoperative or postoperative complications occurred. The postoperative TNM staging was stage I (pyT2N0cM0). No recurrence or metastasis was found at postoperative 7 month. It is a safe, effective and feasible technique for patients with low rectal cancer.
Asunto(s)
Adenocarcinoma/cirugía , Neoplasias del Recto/cirugía , Procedimientos Quirúrgicos Robotizados/métodos , Cirugía Endoscópica Transanal/métodos , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/patología , Anciano , Canal Anal/cirugía , Anastomosis Quirúrgica , Antineoplásicos/administración & dosificación , Colon Sigmoide/cirugía , Humanos , Ileostomía , Laparoscopía/métodos , Masculino , Mesenterio/cirugía , Terapia Neoadyuvante , Neoplasias del Recto/tratamiento farmacológico , Neoplasias del Recto/patología , Recto/cirugía , Estudios Retrospectivos , Procedimientos Quirúrgicos Robotizados/instrumentación , Cirugía Endoscópica Transanal/instrumentaciónRESUMEN
A novel non-contact measurement technique had been developed for the mechanical properties of materials in Split Hopkinson Pressure Bars (SHPB). Instead of the traditional strain gages mounted on the surfaces of bars, two shutters were mounted on the end of bars to directly measure interfacial velocity using Fiber Micro-Displacement Interferometer System for Any Reflector. Using the new technique, the integrated stress-strain responses could be determined. The experimental technique was validated by SHPB test simulation. The technique had been used to investigate the dynamic response of a brittle explosive material. The results showed that the new experimental technique could be applied to the dynamic behavior in SHPB test.