Gastrointestinal Surgery Department of Shanghai General Hospital Completed Shanghai's First Single-hole Distal Gastrectomy with the Fourth-generation Da Vinci Xi Robot

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https://www.shobserver.com/staticsg/res/html/web/newsDetail.html?id=532824

If the abdominal surgery incision is too large and excessive, it is easy to leave multiple scar bumps on the abdominal wall.

The continuous innovation and development of surgical equipment and technology has enabled surgeons to achieve more "minimally invasive", "scarless" and "rapid recovery" concepts while ensuring the treatment effect. Shanghai General Hospital provides more scientific and humanistic medical services for tumor patients. Prof. Chen Huang, Director of Gastrointestinal Surgery (North) of General Surgery Center at Shanghai General Hospital, successfully performed the "4th generation Da Vinci Xi robot single-port distal gastrectomy (Bi-II anastomosis, full intracavitary suture reconstruction)" for a patient with gastric tumor. The surgery made full use of the umbilicus, a natural skin fold, to create an operating channel, which significantly reduced the surgical trauma and greatly preserved the original appearance of the abdomen while achieving therapeutic results and accelerating postoperative recovery.

Mr. Chen, a 71 year old man was found to have a 5x4 cm huge submucosal bulge near the pylorus of the gastric sinus during a physical examination six months ago, and was considered to have a possible tumor of mesenchymal origin. Over the past six months, he went to many hospitals to seek minimally invasive surgery and finally came to Dr.Chen Huang's Clinic.

During the consultation, the specialist learned that Mr. Chen was a "scarred man". If the abdominal surgery incision is too large or too many, even if it is a conventional multi-hole laparoscopic or robotic surgery, it is easy to leave multiple scars on the abdominal wall. This was Chen's biggest concern, and he wanted to reduce the incision to the "smallest" and keep his abdomen intact as much as possible.

After a thorough preoperative evaluation, the surgical team decided to perform the "4th generation da Vinci Xi robotic single-port distal gastrectomy (Bi-II anastomosis with full intracavitary suture reconstruction)" for the patient, who was considered to have a relatively low tumor malignancy and a suitable body size.

On the day of surgery, Dr. Chen Huang led the surgical team to make an incision less than 4 cm long around the patient's umbilicus. A single-port transumbilical puncture device was then used to establish the operating channel, and a robotic robotic arm and laparoscopic instruments were placed to expose and dissect the liver, the distal stomach, the beginning of the duodenum and its surrounding arteries with precise traction. The diseased distal stomach was removed and reconstructed with a total intraluminal gastrojejunostomy. The operation was completed in less than 2 hours with less than 10 ml of intraoperative bleeding. The patient was able to get out of bed the same night after surgery, and was discharged on the fourth day after removal of the gastric tube and eating a liquid diet on the second day after surgery.

In the past two years, Dr.Chen Huang's team at the General Surgery Center-Gastrointestinal Surgery Department at Shanghai General Hospital has been vigorously carrying out the fourth-generation Da Vinci Xi robotic radical gastric cancer surgery and single-hole colorectal cancer surgery, and the total number of related cases is among the highest in Shanghai and even in China. Compared with the traditional laparoscopic and multi-hole robotic surgery, the single-hole gastric surgery with the assistance of the fourth-generation da Vinci Xi robot has smaller incisions, less stimulation to the somatosensory nerves and internal organs, and less postoperative pain, which is conducive to rapid recovery. At the same time, the small incision of 3 to 4 cm around/through the umbilicus can better maintain the integrity of the abdominal wall, which can meet the "cosmetic incision" needs of some patients.

Correspondents: Yangzi Huang, Shijun Xiang, Yang Hu