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机器人前列腺切除术 - Medical Animation

 

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机器人前列腺切除术 - Medical Animation
医学动画文字记录:如果你的前列腺癌没有扩散到前列腺外,医生可能会建议进行机器人根治性前列腺切除术来切除前列腺。前列腺是一个核桃大小的腺体,位于男性膀胱下方,包裹着尿道,尿道是尿液排出身体的管道。大肠的末端叫做直肠,位于前列腺后面。每个精囊与输精管结合形成射精管,射精管连接到前列腺。前列腺癌是前列腺内小管腺组织内细胞的异常生长。随着癌细胞的增殖,就形成了肿瘤。在进行手术前,首先建立静脉通路。通过静脉注射抗生素来减少感染的机会。手术采用全身麻醉。经口腔进行气管插管达到喉以下,以帮助你在术中呼吸。将一根导尿管插入膀胱以排出尿液。医生会在肚脐附近开一个小切口,然后插入一根塑料管,称为孔。通过这个孔将二氧化碳气体泵入腹部。气体会使腹部膨胀,给医生更多的空间来查看和移动手术器械。当腹部充气后,将一个高清摄像头插入这个孔。医生会做额外的切孔,供机器人手术器械以及病人侧助手使用的手术器械(进入身体)使用。助手将把所有的机器人手术器械插入这些孔。与标准的腹腔镜设备不同,这些器械可以360度旋转,比人类的手腕更灵活。医生坐在一个特殊的控制台前,通过类似操纵杆式的控制装置和脚踏板来操作机器人手臂和摄像机。计算机将把医生手指的精确动作转换成手术器械的精确动作。与此同时,高清晰度视觉系统将在机器人手臂到位的情况下提供一个放大的、三维立体的手术区域视图。医生会分离膀胱周围的组织。用弗利导尿管作为引导,医生将切开膀胱和前列腺之间的尿道。每个精囊和输精管将被识别并从膀胱中分离出来。然后切断每根输精管。为了防止直肠损伤,医生会将它从前列腺后部分离出来。为了保护性功能,医生会小心翼翼地分离前列腺两侧的神经和血管。只有当你在手术前有性功能,肿瘤没有扩散到神经,而且医生有必要的技术和经验时,才会执行这个保留神经的操作。接下来,医生会切开前列腺另一端的尿道,这样可以游离前列腺,它就可以被切除了。前列腺附近的淋巴结也可能被切除,以确定癌细胞是否扩散。最后,将尿道重新连接到膀胱上。在手术结束后,将用缝线、缝合钉、手术胶或封闭胶带封闭切口。在膀胱中放置导尿管以保持膀胱排空。通常会在手术后留置1周左右。手术后不久,即可拔除气管插管,你将被带到恢复区进行监测,并根据需要给你止痛药。可能会继续通过静脉注射抗生素,并用无菌溶液间歇地通过导管冲洗出膀胱积聚的血液和凝块。大多数病人在手术后当天或一天后就可以出院。

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