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- 저자 : Masaaki Andou (검색결과 2 건)
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Shiori Yanai,Kiyoshi Kanno,Kiyoshi Aiko,Masaaki Andou 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.1
Objective: In comparison with laparoscopic transperitoneal para-aortic lymphadenectomy,the advantages of laparoscopic extraperitoneal para-aortic lymphadenectomy (ePAL) arethat the operative field is not obstructed by bowel and the Trendelenburg position is notrequired [1]. The ePAL technique has been adopted to the robotic surgery with the da VinciXi. There are only a few reports demonstrating the technical feasibility of robot-assisted ePAL(RAePAL) [2,3]. This report describes the new surgical technique of RAePAL with the bipolarcutting method. Methods: The patient was a 53-year-old woman diagnosed as ovarian clear cell carcinoma(CCC) after left salpingo-oophorectomy. As the re-staging surgery, robot-assisted rightsalpingo-oophorectomy, hysterectomy, omentectomy, and pelvic lymphadenectomy wereplanned following ePAL. The patient was placed in the supine position and tilted 5 degrees tothe right. Three da Vinci arms were docked at the patient's left side (Fig. 1). The bipolar cuttingmethod was performed by with the surgeon's right hand. An AirSeal® port (ConMed, Utica,NY, USA) was placed on the side near the assistant. After the para-aortic space was expanded,lymphadenectomy was performed up to the renal veins with the bipolar cutting method. Results: The PAL operative time was 155 minutes, estimated blood loss was 25 mL. Thepatient developed no perioperative complications, and the postoperative diagnosis was stageIC1 ovarian CCC with no pelvic (n=0/42) and para-aortic lymph nodes (n=0/59) metastasis. Conclusion: RAePAL with the bipolar cutting method was technically feasible. Performinglymphadenectomy between the aorta and the vena cava was facilitated by the articulatedrobotic arm.
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Hiroyuki Kanao,Kazuko Fujiwara,Keiko Ebisawa,Tomonori Hada,Yoshiaki Ota,Masaaki Andou 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.3
Objective: This study was conducted to ascertain the correlation between preserved pelvic nerve networks and bladder function after laparoscopic nerve-sparing radical hysterectomy. Methods: Between 2009 and 2011, 53 patients underwent total laparoscopic radical hysterectomies. They were categorized into groups A, B, and C based on the status of preserved pelvic nerve networks: complete preservation of the pelvic nerve plexus (group A, 27 cases); partial preservation (group B, 13 cases); and complete sacrifice (group C, 13 cases). To evaluate bladder function, urodynamic studies were conducted preoperatively and postoperatively at 1, 3, 6, and 12 months after surgery. Results: No significant difference in sensory function was found between groups A and B. However, the sensory function of group C was significantly lower than that of the other groups. Group A had significantly better motor function than groups B and C. No significant difference in motor function was found between groups B and C. Results showed that the sensory nerve is distributed predominantly at the dorsal half of the pelvic nerve networks, but the motor nerve is predominantly distributed at the ventral half. Conclusion: Various types of total laparoscopic nerve-sparing radical hysterectomies can be tailored to patients with cervical carcinomas.
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