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- 저자 : Charles Jimenez Cruz (검색결과 3 건)
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Charles Jimenez Cruz,Incheon Kang,Woo Jung Lee,Chang Moo Kang 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.3
Chronic pancreatitis is a benign inflammatory process that results symptoms pertaining to loss of endocrine and exocrine function. Pain poses a great challenge in the management of CP and intractable pain represents the main indication for surgical intervention. Surgical options for CP ranges from pancreatic resection to pure drainage procedures. Herein, we present the case of 68 year-old female with recurrent abdominal pain due to chronic pancreatitis, who underwent successful laparoscopic pancreatic neck transection and double pancreatico-jejunostomy (duct-to-mucosa). Pre-operative imaging revealed a uniformly dilated pancreatic duct with encrusted pancreatic stone in the pancreatic head near the ampulla of Vater, with no inflammatory mass. Pre-operative laboratory work-ups were all normal. Pancreas texture was noted to be intermediate to soft. During pancreatic neck transection, there was spontaneous deviation of distal stump laterally leaving an ample space to accommodate jejunal loop. PD measured 8 mm. The standard duct to mucosa double layer simple interrupted suture was used for PJ anastomosis. There were no significant intra-operative events. No transfusion was required. Total operation time was 297 minutes, and it took 129 minutes for laparoscopic PJ completion. Immediate post-operative course was unremarkable. This case suggests laparoscopic double PJ can be an alternative surgical approach to reduce the pancreatic duct pressure in chronic pancreatitis. Based on accumulating experiences, long-term outcome also needs to be investigated to address potential role of this technique.
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Technical feasibility of da Vinci SP single-port robotic cholecystectomy: a case report
Charles Jimenez Cruz,Hye Yeon Yang,Incheon Kang,강창무,이우정 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.4
The da Vinci surgical system released its new pure single-port platform, the da Vinci SP, offering improvements and refinements for established robotic single-site procedures. Herein, we present the first case of robotic single-site cholecystectomy using the da Vinci SP system (RSPC) demonstrating its safety and technical feasibility. A 59-year-old female with chronic calculus cholecystitis was admitted for elective RSPC. Docking time took 6 minutes. The patient underwent successful RSPC with a total operation time of 89 minutes. There was no significant intraoperative event. The patient had unremarkable postoperative course. Multijoint instruments, simple docking process, and third-arm functionality are among the RSPC’s advantages. Absence of the port for an assistant surgeon can be a hindrance in performing more complicated surgeries. The present case suggests that RSPC is safe and feasible. The promising features and potential application of da Vinci SP in hepatobiliary and pancreas surgery need further study
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Charles Jimenez Cruz,Frederick Huynh,Incheon Kang,Woo Jung Lee,Chang Moo Kang 대한외과학회 2021 Annals of Surgical Treatment and Research(ASRT) Vol.100 No.1
Purpose: The da Vinci SP robotic surgical system (Intuitive Surgical) offers pure SP with 4 lumens, which accommodates the fully-wristed endoscope and 3 arms with multijoint feature. We herein present our initial experience of the da Vinci SP surgical system in robotic single-site cholecystectomy. Methods: Thirty consecutive patients with a preoperative diagnosis of gallstones and/or chronic cholecystitis who underwent robotic SP cholecystectomy (RSPC) using da Vinci SP surgical system from January to May 2019 were reviewed. The perioperative outcomes were assessed and compared with those performed using Si-robotic single-site surgical system. Results: Mean docking time was 5.2 minutes. The mean actual dissection time was 14.6 minutes while the mean operation time was 75.1 minutes. Postoperative course was unremarkable and patients were discharged after a mean hospital stay of 1.5 days. In comparative analysis, operation time (109.5 ± 30.0 minutes vs. 75.1 ± 17.5 minutes, P = 0.001), docking time (11.9 ± 4.3 minutes vs. 5.2 ± 1.9 minutes, P = 0.001), actual dissection time (34.6 ± 18.4 minutes vs. 14.6 ± 5.1 minutes, P = 0.001), console time (58.7 ± 23.0 minutes vs. 32.4 ± 11.6 minutes, P = 0.001), immediate postoperative pain (4.6 ± 1.3 vs. 3.2 ± 1.0, P = 0.001), and pain prior to discharge (2.0 ± 0.6 vs. 1.4 ± 0.0, P = 0.002) were significantly improved in RSPC. Conclusion: RSPC is feasible, safe, and effective. The perioperative outcomes are better compared with Si-robotic single-site surgical systems.
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