Analysis Of The Efficacy Of Davinci Xi Robotic Surgical System In Gynecologic Tumor Operation

Objective:By comparing a series of related indexes during and after robotic surgery and traditional laparoscopic surgery,to analyze the feasibility,safety and effectiveness of robotic surgical system in gynecologic operation.Methods:A total of 164 patients with gynecological benign and malignant tumors admitted to our hospital from September 2018 to February 2021 were selected as the research subjects,and were divided into benign and malignant groups according to benign and malignant tumors.A total of 127 patients were in the benign group,of which 59 patients were treated with Da Vinci robot system(robot group)and 68 patients were treated with conventional laparoscopic surgery(laparoscopic group).Patients in the benign group were divided into <12 gestational age group and ≥12gestational age group according to uterine size.There were 37 patients in the malignant group,of which 15 patients received surgical treatment with the robotic system(the robot group)and 22 patients received surgical treatment with conventional laparoscopy(the laparoscopic group).All the operations included in the study were performed by the same gynecologist,and the data were collected and followed up by a special person.The operative time,intraoperative blood loss,number of resected lymph nodes,postoperative exhaust time,time of first getting out of bed,drainage volume 48 hours after surgery,postoperative pain degree,postoperative hospital stays,and incidence of intraoperative and postoperative complications(bleeding,infection,adjacent organ injury)in 2 groups were observed.Results:1.Comparison of indicators of robot application and laparoscopy in benign tumors(1)Comparison of various indicators between robotic and laparoscopic treatment in patients with uterine size <12 weeks of gestationThe amount of intraoperative blood loss in the robot group was(121.30±22.05)ml less than that in the laparoscopic group(133.69±19.99)ml.The first time of getting out of bed in the robot group was(1.26±0.25)d shorter than that in the laparoscopic group(1.52±0.23)d.The length of hospital stay in the robot group(5.82±1.02)d was shorter than that in the laparoscopic group(6.49±1.20)d,P<0.05,the differences were statistically significant.The operation time of the robot group was(98.21±17.67)min shorter than that of the laparoscopic group(106.96±27.76)min.The incidence of intraoperative and postoperative complications in the robot group(10.3%)was lower than that in the laparoscopic group(11.3%).The first anal exhaust time of the robot group was(1.61±0.27)d shorter than that of the control group(1.71±0.31)d.The postoperative drainage volume in the robot group was(128.01±24.94)ml more than that in the laparoscopic group(120.05±17.48)ml.The degree of postoperative pain in the robot group(1.44±0.21)was lower than that in the laparoscopic group(1.52±0.19),P>0.05,the difference was not statistically significant.(2)Comparison of various indicators between robotic and laparoscopic treatment in patients with uterine size ≥12 weeks of gestationThe operation time of the robot group was(150.19 ± 33.22)min shorter than that of the laparoscopic group(180.23 ± 38.89)min.The amount of intraoperative blood loss in the robot group was(180.39±19.89)ml more than that in the laparoscopic group(153.27±20.89)ml.The first anal exhaust time of the robot group was(1.90±0.34)d shorter than that of the control group(2.41±0.45)d.Postoperative drainage volume in the robot group was(180.90±15.02)ml less than that in the laparoscopic group(200.53±23.50)ml.The length of hospital stay in the robot group(6.83±1.44)d was shorter than that in the laparoscopic group(7.74±2.40)d,P<0.05,the differences were statistically significant.The incidence of intraoperative and postoperative complications in the robot group(10.0%)was lower than that in the laparoscopic group(20.0%).The first time to get out of bed in the robot group was(1.78±0.22)d shorter than that in the laparoscopic group(1.83±0.26)d.Postoperative pain in the robot group(1.89±0.31)was lower than that in the laparoscopic group(1.99±0.37),P>0.05,the difference was not statistically significant.2.Comparison of indicators between the application of robot and laparoscopy in malignant tumorsThe operation time of the robot group was(170.46±40.12)min shorter than that of the laparoscopic group(187.33±22.11)min.The intraoperative blood loss(220.89±27.89)ml was less than that of the laparoscopic group(285.72±30.65)ml.The number of lymph nodes removed in the robot group was(12.16±5.33)more than that in the laparoscopic group(10.00±1.98).The first time of getting out of bed in the robot group was(1.82±0.18)d shorter than that in the laparoscopic group(1.98±0.19)d.The degree of postoperative pain in the robot group(2.36±0.71)was lower than that in the laparoscopic group(3.26±0.64).The length of hospital stay in the robot group was(9.64±4.22)d shorter than that in the laparoscopic group(11.33±1.70)d,P<0.05,and the differences were statistically significant.The incidence of intraoperative and postoperative complications in the robot group(20%)was lower than that in the laparoscopic group(22.7%).The first anal exhaust time of the robot group was(2.36±0.19)d shorter than that of the control group(2.49±0.25)d.The postoperative drainage volume in the robot group was(256.95±15.25)ml more than that in the laparoscopic group(249.00±20.46)ml,P>0.05,the difference was not statistically significant.Conclusions:1.The application of Da Vinci robotic surgical system in gynecological benign and malignant tumors can shorten the operation time,reduce intraoperative bleeding,and accelerate postoperative recovery to a certain extent,with more obvious advantages in patients with large uterus.2.The application of Da Vinci robotic surgical system in gynecological malignant tumor surgery can remove more pelvic lymph nodes and reduce the risk of recurrence.