To remove a kidney tumor of the same size as the kidney, you only need to cut three or four small incisions of 1 cm, which can be completed in more than two hours. The patient can be discharged from the hospital one day after three days and four days. Modern high-tech assisted tumor resection surgery can really do this. The operation is no longer "opening the belly", bleeding, hospitalization for several months... Recently, the urology department of Zhongda Cancer Hospital has completed such a difficult and difficult renal tumor resection, and the Da Vinci surgical robot and 3D printing technology are combined. A set of "combination punches" has made a wonderful contribution to the success of the operation. The reporter went to the camp to uncover the tumor resection under the help of high technology.
45-year-old IT male medical examination
Found huge kidney tumor
Mr. Hu, 45, has worked for an IT foreign company and has not undergone a medical examination since he left the company five years ago. It was not until the end of June this year that a medical examination was conducted under the advice of his wife. I did not expect to find a big problem: the kidney B-ultrasound showed that his right kidney was attached with a mass of up to 9 cm, and the volume of the whole tumor was almost as large as the right kidney. Initial diagnosis of kidney cancer, a number of hospitals said that the kidney is too difficult, it is recommended to directly remove the entire right kidney. Finally, Mr. Hu came to the Cancer Hospital of Sun Yat-sen University. "I am still so young, I am afraid that there is only one kidney health risk in the future. Of course, I still hope that I can guarantee it. Da Vinci robot surgery is a new thing. I have not done many people, but I think it is worth a try. Willing to take risks for this," said Mr. Hu.
At the beginning of July, at the urology department of Zhongda Cancer Hospital, Professor Han Hui received Mr. Hu. After a series of evaluations and repeated communication, taking into account the patient's strong willingness to preserve the kidney, after explaining the risk to the patient, the chief expert of the urological kidney cancer single disease team, Han Hui, the chief physician team decided to remove the tumor for Mr. Hu. Kidney preservation surgery. On July 20, Mr. Hu successfully underwent surgery. On July 25, the reporter saw Mr. Hu in the hospital. He is now recovering quickly and is ready to be discharged.
"Black Technology" helps out
"From the current point of view, the operation is very smooth and the patient's prognosis is also very good." Professor Han Hui said that the operation was very calm. Behind this "comfortable" is the powerful help of three high-tech new technologies: pre-operative 3D imaging simulates all the details of the kidney tumor, helping to plan the surgical path; during the operation, Da Vinci robotic armor, using a dedicated probe to do B Ultra-exploration, accurate vascular occlusion, mass resection, and wound suture according to the planned path; and “see-through eye†to monitor the lesion in real time.
Preoperative 3D print lesion "kidney" to "preview"
In the planning stage of surgery, Han Hui team used 3D technology to reconstruct CT image scanning information on the computer for three-dimensional reconstruction, and reconstructed the spatial relationship of various important organizational structures such as blood vessels and tumors. Then, using the 3D printing technology, a one-to-one model of Mr. Hu’s right kidney was generated. This model uses a translucent material that can accurately and clearly mark the boundaries and correspondence between different structures such as blood vessels, renal pelvis, and tumors inside the kidney. "In the past, even if you opened the knife into the inside of the lesion, you can't see it so clearly. Now through this reconstruction, the doctor seems to wear the see-through glasses, and can simulate the surgical scene to the maximum extent before surgery, accurately assess the lesions, and plan the operation. The path minimizes the normal function of the organ while exfoliating the mass, minimizing damage to normal tissue."
Han Hui said that the application of 3D technology in the medical field is a key project of the Guangzhou University of Industry, Research and Research, which is jointly applied by the Zhongda Cancer Center. It is of great significance in the treatment of kidney tumors because kidney cancer is a tumor rich in blood. Recognize the direction of blood vessels and their branches when "peeling tumors and kidneys". Preoperative 3D reconstruction technology enables doctors to accurately grasp the blood supply of tumors and normal tissues, accurately plan the anatomy of blood vessels, and directly determine the amount of intraoperative blood loss. Precise resection of the tumor and maximum retention of postoperative renal function in the patient.
Intraoperative doctors manipulate Da Vinci's robotic arm
Han Hui introduced that minimally invasive surgery is the latest trend in surgery. The first generation of minimally invasive surgeons can only use laparoscopic surgical instruments such as scissors and pliers with only one joint; the second generation of minimally invasive surgery has evolved into the robot era, with the exception of imaging systems, the most powerful The joints at the front end of the arm are greatly "upgraded", and multiple joints can be rotated at any angle, creating conditions for fine cutting, peeling, stitching, etc., which is equivalent to a reduced version and an upgraded version of the human hand, and is more flexible than the human hand. ,more stable.
What is the experience of operating a robotic arm for minimally invasive surgery? Han Hui said that just like playing a "sense game", the robotic arm is the "extension" of the doctor's hand, and it can accurately execute all the instructions conveyed by the doctor's brain and hands. As long as a small opening is made in the affected area, the arm can be extended into the internal operation until the last time the mass is removed, the diameter of the wound is slightly enlarged according to the smallest diameter of the tumor, and the wound has been removed by the smallest possible wound. The mass was removed from the body.
Feeding robot arm holds "perspective eye" to monitor lesions
During the operation, in order to understand the tumor in real time, the "perspective eye" was also dispatched. The doctor uses a robotic arm to hold a pen-sized intraoperative B-ultrasonic probe that allows for a full-scale, non-dead-angle exploration of tumor and normal tissue boundaries, dynamically validating or adjusting preoperative 3D planning. The program allows the scalpel to be placed on the fluoroscopy eye to avoid damage to important structures around it and to ensure that the resection is more foolproof.
Under the strong blessing of the three "black technologies", the operation was completed in 2.5 hours. Han Hui said that such a difficult and difficult kidney tumor operation was completely "impossible to complete" five years ago. Even now, the hospital will complete up to 30 cases per year.
It is internationally recognized that kidney tumors below 4 cm can be routinely removed and preserved; 7 cm to 10 cm of renal tumors, only a few doctors in very few hospitals can preserve kidneys after thorough communication with a small number of patients who can identify with the program. .
"It is also because of the development of technology that we can do this." Han Hui lamented.
Reminder: Regular physical examination is very important
I have talked about the high-precision surgery under the help of black technology. Doctors want to remind the public that it is very important to check the health of the body regularly. Speaking of the experience of discovering tumors, Mr. Hu also lamented that he usually does not smoke or drink alcohol, go to bed early and get up early, and there is no bad habit. Before the physical examination, except for mild fatty liver, almost no problems were found. Unexpectedly, after a few years, in the case of ignorance, it was a big surprise to find out the serious illness.
Han Hui said that kidney tumors are one of the three major tumors common in the urinary system. The pathogenesis of the kidney tumors is not clear at present. Most of the early tumors have no obvious symptoms and can only be found by physical examination. At present, more than one-third of the patients undergoing kidney-removing tumor surgery performed by the center each year are found to be sick during physical examination. Moreover, for kidney tumors, tumors below 4 cm are effectively and safely surgically removed, and their five-year survival rate is over 90%. Therefore, it is important to capture the danger signs of good health through regular physical examinations.
Source: Guangzhou Daily
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