Cruz-Ordoñez SX, Torres-Gómez JJ, Estrada-Carrasco CE, Martínez-Alonso IA, Campos-Salcedo JG

Language: Spanish
References: 8
Page: 1-6
PDF size: 510.49 Kb.

ABSTRACT

Objetive: Minimize morbidity in assisted laparoscopic robot nephrectomy with the extraction of the piece by natural orifices, as well as standardize the robotic laparoscopic assisted surgical technique with the extraction of the transvaginal piece in order to identify the pertinent steps and possible responses of this approach.
Metodology: It is a female patient of the fourth decade of life, multiparous, a history of recurrent urinary tract infection, secondary to right renal hypoplasia, documentation with the exclusion of renal function by renal gammagram, so it is presented as a technique surgical procedure, performing a transperitoneal approach with assisted laparoscopic robot.
Results: Two robotic trocars and a trocar accessory were used in the bottom of the Douglas pouch, with an operation time of 45 minutes after the coupling, robot, patient, with transoperative bleeding quantified in 30 ml. The length of hospital stay was 2 days, with an average time of analgesic use of 5 days; in the post-operative period so that the patient has as a complication the presence of the urinary tract infection that treatment with antibiotic therapy, without other complications.
Conclusion: The assisted laparoscopic robot approach with the use of natural origins for the extraction of the surgical piece, reduce the cost and morbidity and post-operative of the patients to this type of approach, likewise reduce the surgical time, the transoperative bleeding, the stay hospitalization and the use of analgesics.

REFERENCES

1. Fiorentino RP, Zepeda MA, Goldstein BH, John CR, Rettenmaier MA. Pilot study assessing robotic laparoscopic hysterectomy and patient outcomes. J Minim Invasive Gynecol. 2006;13(1):60–3. doi: https://doi. org/10.1016/j.jmig.2005.11.001

2. Veljovich DS, Paley PJ, Drescher CW, Everett EN, Shah C, Peters WA. Robotic surgery in gynecologic oncology: program initiation and outcomes after the first year with comparison with laparotomy for endometrial cancer staging. Am J Obstet Gynecol. 2008;198(6):679. e1-9; discussion 679.e9-10. doi: https://doi. org/10.1016/j.ajog.2008.03.032

3. Sarlos D, Kots L, Stevanovic N, Schaer G. Robotic hysterectomy versus conventional laparoscopic hysterectomy: outcome and cost analyses of a matched case-control study. Eur J Obstet Gynecol Reprod Biol. 2010;150(1):92–6. doi: https://doi.org/10.1016/j.ejogrb.2010.02.012

4. Lee C-L, Wu K-Y, Su H, Han C-M, Huang C-Y, Yen C-F. Robot-assisted natural orifice transluminal endoscopic surgery for hysterectomy. Taiwanese Journal of Obstetrics and Gynecology. 2015;54(6):761–5. [accessed 3 Sep 2019] Available from: http://www. sciencedirect.com/science/article/pii/ S1028455915002375

5. Alcaraz A, Peri L, Molina A, Goicoechea I, García E, Izquierdo L, et al. Feasibility of Transvaginal NOTES-Assisted Laparoscopic Nephrectomy. European Urology. 2010;57(2):233–7. [accessed 3 Sep 2019] Available from: https://www.europeanurology. com/article/S0302-2838(09)00953-1/abstract

6. Box GN, Bessler M, Clayman RV. Transvaginal Access: Current Experience and Potential Implications for Urologic Applications. Journal of Endourology. 2009;23(5):753–7. [accessed 3 Sep 2019] Available from: https://www. liebertpub.com/doi/10.1089/end.2009.0150

7. Pillai R, Yoong W. Posterior colpotomy revisited: a forgotten route for retrieving larger benign ovarian lesions following laparoscopic excision. Arch Gynecol Obstet. 2010;281(4):609–11. [accessed 3 Sep 2019] Available from: https:// doi.org/10.1007/s00404-009-1138-5

8. Allaf ME, Singer A, Shen W, Green I, Womer K, Segev DL, et al. Laparoscopic Live Donor Nephrectomy with Vaginal Extraction: Initial Report. American Journal of Transplantation. 2010;10(6):1473–7. [accessed 3 Sep 2019] Available from: https://onlinelibrary.wiley.com/ doi/abs/10.1111/j.1600-6143.2010.03131.x