奇美醫院引進達文西機械手臂10年 提供民眾更好的醫療選擇
2023-2-10 記者田靖／台南報導
泌尿外科主治醫師曾文歆（圖＿奇美醫院提供）。
奇美醫學中心為南臺灣率先引進達文西機械手臂的醫院，幫助腫瘤切除後的腎臟重建縫合，10年累積了近千台的經驗。達文西機械手臂可以模擬跟手一樣的3D角度，並搭配放大10倍更細緻的達到止血及縫合的動作。目前奇美醫學中心腎臟局部切除手術，最大的腫瘤已達12公分，甚至緊貼著腎臟動靜脈的腫瘤也可以精準地將腫瘤完整的切下，並避開血管做縫合。
達文西微創手術在奇美醫學中心經過十年努力與近300台的經驗下，提升了腎臟局部切除手術的極限，大幅減少需要做到腎臟全切手術的機會。經由泌尿科醫師先鋒的角色努力下，讓更多病人及醫師知道達文西手術的安全、精準及快速恢復。進而也讓衛福部預計在今(2023)年將「肝部分切除術」等17項達文西手術費也納入健保部分給付的範圍。
達文西獨特的器械可具有多個，而且靈活自由旋轉的角度和方向控制，可以模仿人類雙手做旋轉、抓取、捏夾的動作，優於傳統腹腔鏡僵直（圖＿奇美醫院提供）。
奇美醫學中心泌尿外科主治醫師曾文歆指出：根據衛生福利部過去10年的統計，泌尿上皮癌發生率高居男生癌症發生率的前10名。而其中肌肉侵犯型的膀胱癌又占了初診斷膀胱癌的四分之一，由於其高復發及轉移風險，讓醫師及病人在治療上往往絞盡腦汁。
肌肉侵犯型的膀胱癌病人以往在傳統剖腹式膀胱全切除手術上，多半恢復期較長、傷口大(超過20公分)，又因尿道無法精密縫合導致有尿失禁或是需要終身放置尿袋或導尿管的情況，因此常讓病人舉足不前，陷入考慮是否改做化療加上電療。但自從使用達文西輔助手術後，不僅讓傷口大幅減小，僅有5個不到1公分的小傷口，加上將膀胱及腫瘤取出的下腹部傷口約5至7公分，手術中大幅減少出血量，且過去採用腹腔鏡手術因骨盆腔過深導致無法縫合情況，在達文西機械手臂輔助下可於不同角度及視野下完成，更減少術後漏尿情況，有效提升病人生活品質。後續僅需定期追蹤影像，不必持續接受膀胱鏡檢查，免除了接受膀胱鏡檢查時的煎熬。
奇美醫學中心泌尿外科主治醫師曾文歆實際於達文西機械系統之駕駛艙操作微創手術（圖＿奇美醫院提供）。
曾文歆表示：手術後的重建對病人的恢復及預後非常重要，包括攝護腺根除手術後的尿道膀胱接合及腎臟局部切除手術後的腎臟縫合止血。因此如何讓病人接受更完善的醫療，縮短手術時間、術中出血量最少、降低併發症產生、快速出院回復日常生活，解決疾病帶來的困擾，一直是每位外科醫師的究極目標。達文西機械手臂輔助治療是讓民眾享有更好的治療選擇之一，在勇敢面對疾病的同時，與醫師共同討論，做出對於自己身體狀況最好的選擇。
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