■襟翼和移植物用于填充死区,输尿管置换,并作为网格替代品。由于机器人能够到达深骨盆,因此手术机器人在泌尿外科重建手术中非常宝贵,它的微创通道,使用吲哚菁绿来识别结构并评估组织灌注和活力的能力,和外科医生的人体工程学。机器人重建可以涉及皮瓣和移植物形式的组织转移,以向因医源性损伤而受损的器官提供形式和功能,创伤,感染,癌症,辐射损伤,或先天性异常。常见的皮瓣和移植物可以容易地适应机器人方法。在这篇文献综述中,我们研究了在重建泌尿外科中使用皮瓣和移植物的机器人。
■通过PubMed搜索预定义术语进行了全面的文献综述。
■重建泌尿外科中的皮瓣和移植物用于插入,输尿管置换,并作为网格替代品。Omental皮瓣用于组织插入,或者提供结构和营养,并且很容易与机器人一起使用。已经描述了腹膜皮瓣的各种机器人应用。腹直肌肌皮瓣是血管化良好的皮瓣,占据死腔并提供结构支持。可以用机器人很容易地收获。乙状结肠表观是骨盆重建的优良皮瓣。龙舌兰皮瓣和阔筋膜移植物耐受性良好,可提供占位组织。Boari皮瓣有助于机器人输尿管重建,尤其是在设置长缺陷时。口腔粘膜非常适合输尿管或膀胱颈重建。直肠粘膜具有良好的耐受性,并且易于通过机器人进行各种尿路重建应用。可以插入阑尾或回肠以修复受损的输尿管。
■各种皮瓣和移植物已适用于机器人重建泌尿外科。随着领域的发展,技术的完善和创新的襟翼和机器人的使用将推动这一领域向前发展。更多研究,尤其是比较研究,需要阐明每个用例最有可能成功且发病率最低的皮瓣和移植物。
UNASSIGNED: Flaps and grafts are used for filling dead space, ureteral substitution, and as mesh alternatives. The surgical robot is invaluable in urologic reconstructive surgery due to the ability of the robot to reach the deep pelvis, its minimally invasive access, the ability to use indocyanine green to identify structures and assess tissue perfusion and viability, and ergonomics for the surgeon. Robotic reconstruction can involve tissue transfer in the form of flaps and grafts to provide form and function to organs that have been damaged by iatrogenic injuries, trauma, infections, cancer, radiation injury, or congenital abnormalities. Common flaps and grafts can be readily adapted to the robotic approach. In this literature review, we examine the robotic use of flaps and grafts in reconstructive urology.
UNASSIGNED: A thorough literature review was conducted via a PubMed search for predefined terms.
UNASSIGNED: Flaps and grafts in reconstructive urology are used for interposition, ureteral substitution, and as mesh alternatives. Omental flaps are used for tissue interposition, or to provide structure and nutrients, and are easily employed with the robot. Various robotic applications of peritoneal flaps have been described. Vascular rectus abdominis musculocutaneous flaps are well-vascularized flaps that occupy dead space and provide structural support, which can be harvested readily with the robot. Sigmoid epiploica are an excellent flap for pelvic reconstruction. Gracilis flaps and fascia lata grafts are well-tolerated and provide space occupying tissue. Boari flaps aid in robotic ureteral reconstruction, especially in the setting of long defects. Oral mucosa is excellent for ureteral or bladder neck reconstruction. Rectal mucosa is well-tolerated and easy to harvest robotically for a variety of urinary tract reconstructive applications. The appendix or ileum can be interposed for repair of damaged ureters.
UNASSIGNED: Various flaps and grafts have been adapted for robotic reconstructive urology. As the field develops, refinement of techniques and innovation in flaps and employment of the robot will propel this field forward. More studies, especially comparative studies, are needed to elucidate the flaps and grafts that are most likely to be successful with the least morbidity for each use case.