Nemocnice sv. Zdislavy v Mosti\u0161t\u00edch pat\u0159\u00ed mezi \u0161pi\u010dkov\u00e1 evropsk\u00e1 centra, kter\u00e1 nab\u00edz\u00ed sv\u00fdm pacient\u016fm specializovan\u00e9 operace pomoc\u00ed robotick\u00e9 chirurgie. Miniinvazivn\u011b se prov\u00e1d\u00ed celou \u0159adou v\u00fdkon\u016f, v\u010detn\u011b radik\u00e1ln\u00edch operac\u00ed prostaty.<\/p>\n
Princip robotick\u00e9 chirurgie je jednoduch\u00fd.
\n\u010c\u00edm p\u0159esn\u011bji je operace prov\u00e1d\u011bna a \u010d\u00edm m\u00e9n\u011b okoln\u00edch tk\u00e1n\u00ed je zasa\u017eeno, t\u00edm l\u00e9pe pro pacienta. Aby bylo mo\u017en\u00e9 takov\u00e9ho v\u00fdsledku dos\u00e1hnout, pom\u00e1h\u00e1 chirurgovi robot, kter\u00e9ho operat\u00e9r \u0159\u00edd\u00ed. Nen\u00ed to tedy tak, \u017ee by robot operoval „s\u00e1m“, ale d\u00edky jeho pou\u017eit\u00ed je mo\u017en\u00e9 dos\u00e1hnout v\u00fdrazn\u011b krat\u0161\u00ed rekonvalescence, a tak se pacient vrac\u00ed zp\u011bt ke sv\u00e9mu b\u011b\u017en\u00e9mu \u017eivotu je\u0161t\u011b d\u0159\u00edve ne\u017e p\u0159i klasick\u00e9 b\u0159i\u0161n\u00ed operaci nebo laparoskopii. K evropsk\u00fdm centr\u016fm, kde se robotick\u00e9 chirurgii u\u017e \u0159adu let \u00fasp\u011b\u0161n\u011b v\u011bnuj\u00ed, pat\u0159\u00ed Centrum robotick\u00e9 chirurgie Vyso\u010dina, kter\u00e9 je sou\u010d\u00e1st\u00ed Nemocnice sv. Zdislavy v Mosti\u0161t\u00edch. Zde pracuj\u00ed s p\u0159\u00edstrojem nov\u00e9 generace unik\u00e1tn\u00edho robotick\u00e9ho syst\u00e9mu da Vinci. Ten umo\u017e\u0148uje je\u0161t\u011b v\u011bt\u0161\u00ed p\u0159esnost, lep\u0161\u00ed manipulaci opera\u010dn\u00edch ramen a naprosto bezpe\u010dn\u00fd opera\u010dn\u00ed provoz.
\n„Nov\u00fd syst\u00e9m p\u0159in\u00e1\u0161\u00ed maxim\u00e1ln\u00ed p\u0159esnost opera\u010dn\u00edho v\u00fdkonu p\u0159i znateln\u011b v\u011bt\u0161\u00ed mo\u017enosti pohybu a manipulaci opera\u010dn\u00edch ramen p\u0159i prob\u00edhaj\u00edc\u00edm z\u00e1kroku. Nov\u00fd syst\u00e9m da Vinci je men\u0161\u00ed ne\u017e p\u0159edchoz\u00ed typ, m\u00e1 technicky dokonalej\u0161\u00ed opera\u010dn\u00ed p\u0159\u00edstroje a p\u0159enos obrazu opera\u010dn\u00edho pole nab\u00edz\u00ed v rozli\u0161en\u00ed Super HD.
\nT\u00edm p\u0159in\u00e1\u0161\u00ed v\u011bt\u0161\u00ed komfort jak pro l\u00e9ka\u0159eoperat\u00e9ra, tak pro samotn\u00e9ho pacienta,“ \u0159\u00edk\u00e1 Jaroslav Tvar\u016f\u017eek, prim\u00e1\u0159 chirurgick\u00e9ho odd\u011blen\u00ed Nemocnice sv. Zdislavy v Mosti\u0161t\u00edch, kterou provozuje spole\u010dnost VAMED Mediterra. D\u016fvod\u016f, pro\u010d na tomto pracovi\u0161ti operuj\u00ed za pomoci robota da Vinci, je hned n\u011bkolik.
\n„Jsme vedeni snahou o co mo\u017en\u00e1 nej\u0161etrn\u011bj\u0161\u00ed p\u0159\u00edstup ke tk\u00e1n\u00edm, kter\u00e9 m\u00e1me operovat, a usilujeme tak\u00e9 o co nej\u0161etrn\u011bj\u0161\u00ed p\u0159\u00edstup do opera\u010dn\u00edho pole, z \u010deho\u017e v situac\u00edch, kter\u00e9 dosud vy\u017eadovaly velkou opera\u010dn\u00ed r\u00e1nu a souvisej\u00edc\u00ed bolestivost v poopera\u010dn\u00edm obdob\u00ed, plyne minim\u00e1ln\u00ed bolestivost. Jeli operace po celou dobu v\u00fdkonu \u0161etrn\u00e1 a p\u0159ehledn\u00e1, sn\u00ed\u017e\u00ed se mo\u017enost ne\u017e\u00e1douc\u00edho po\u0161kozen\u00ed okoln\u00edch struktur,“ popisuje chirurg, kter\u00fd je mimo jin\u00e9 \u010dlenem americk\u00e9 asociace chirurg\u016f da Vinci Surgery a pom\u00e1hal zav\u00e9st robotick\u00e9 operace v \u010cesku.
\nVe srovn\u00e1n\u00ed s laparoskopi\u00ed, kter\u00e1 je ji\u017e p\u0159es 20 let rutinn\u00ed metodou operov\u00e1n\u00ed, nab\u00edz\u00ed robot da Vinci nesrovnateln\u011b v\u011bt\u0161\u00ed rozsah pohyb\u016f chirurgick\u00fdch n\u00e1stroj\u016f p\u0159i operaci. Uveden\u00fd rozsah pohyb\u016f je umo\u017en\u011bn tzv. endoskopick\u00fdm z\u00e1p\u011bst\u00edm endowrist. Dokonal\u00e9 n\u00e1stroje lze spolehliv\u011b vyu\u017e\u00edt zejm\u00e9na v m\u00edstech, kde je lidsk\u00e1 ruka p\u0159\u00edli\u0161 velk\u00e1, a tedy neobratn\u00e1, nebo kde b\u011b\u017en\u00e9 laparoskopick\u00e9 n\u00e1stroje nelze nastavit do po\u017eadovan\u00e9ho sklonu k operovan\u00e9 tk\u00e1ni tak, aby byl v\u00fdkon bezpe\u010dn\u00fd.<\/p>\n
P\u0159esn\u011bj\u0161\u00ed operace n\u00e1dor\u016f prostaty<\/p>\n
Roboticky je mo\u017en\u00e9 prov\u00e1d\u011bt tak\u00e9 operace prostaty, kter\u00e9 jsou dobr\u00fdm p\u0159\u00edkladem toho, jak modern\u00ed technologie postupuj\u00ed vp\u0159ed ve prosp\u011bch pacient\u016f. Na rozd\u00edl od otev\u0159en\u00e9 operace se p\u0159i miniinvazivn\u00ed roboticky asistovan\u00e9 radik\u00e1ln\u00ed prostatektomii do pacienta zav\u00e1d\u00ed z n\u011bkolika drobn\u00fdch vpich\u016f robotick\u00e9 n\u00e1stroje, kter\u00e9 dokonale p\u0159en\u00e1\u0161\u00ed v\u0161echny pohyby operat\u00e9rov\u00fdch rukou, p\u0159i mnohon\u00e1sobn\u00e9m zv\u011bt\u0161en\u00ed a 3D zobrazen\u00ed. „Pomoc\u00ed t\u011bchto n\u00e1stroj\u016f je mo\u017en\u00e9 precizn\u011b odstranit n\u00e1dorem posti\u017eenou tk\u00e1\u0148 \u2013 prostatu, semenn\u00e9 v\u00e1\u010dky a n\u011bkdy i p\u00e1nevn\u00ed uzliny \u2013 p\u0159i maxim\u00e1ln\u00edm \u0161et\u0159en\u00ed okoln\u00edch tk\u00e1n\u00ed mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e a mo\u010dov\u00e9 trubice, sval\u016f umo\u017e\u0148uj\u00edc\u00edch udr\u017een\u00ed mo\u010di, nerv\u016f a c\u00e9v nutn\u00fdch k erekci. Zv\u011bt\u0161en\u00ed obrazu hluboko v p\u00e1nvi usnadn\u00ed i op\u011btovn\u00e9 spojen\u00ed hrdla mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e s mo\u010dovou trubic\u00ed, kter\u00e1 byla odstran\u011bn\u00edm prostaty p\u0159eru\u0161ena,“ popisuje prim\u00e1\u0159 Tvar\u016f\u017eek. Zhoubn\u00e9 n\u00e1dory prostaty p\u0159itom postihuj\u00ed \u010dasto i mu\u017ee mezi 40. a\u017e 60. rok v\u011bku, tedy v dob\u011b, kdy rozhodn\u011b necht\u011bj\u00ed rezignovat na aktivn\u00ed \u017eivot, v\u010detn\u011b sexu.
\nV\u00fdhodou robotick\u00e9ho z\u00e1kroku je lep\u0161\u00ed kontrola kompletn\u00edho odstran\u011bn\u00ed cel\u00e9ho n\u00e1doru. \u0158ada studi\u00ed ukazuje, \u017ee zku\u0161en\u00fd operat\u00e9r dosahuje pomoc\u00ed robotick\u00e9ho syst\u00e9mu men\u0161\u00edho rizika ponech\u00e1n\u00ed n\u00e1dorov\u00fdch bun\u011bk v posti\u017een\u00e9 oblasti, a tedy vy\u0161\u0161\u00ed \u0161ance k vyl\u00e9\u010den\u00ed. Roboticky operovan\u00ed mu\u017ei tak\u00e9 nemaj\u00ed velkou jizvu na b\u0159i\u0161e jako p\u0159i otev\u0159en\u00e9 operaci. U pacient\u016f, u nich\u017e byly b\u011bhem operace u\u0161et\u0159eny nervy nutn\u00e9 k erekci, je popisov\u00e1n tak\u00e9 rychlej\u0161\u00ed n\u00e1vrat erektiln\u00edch funkc\u00ed. Preciznost n\u00e1stroj\u016f toti\u017e umo\u017e\u0148uje lep\u0161\u00ed ochranu nerv\u016f p\u0159ed poran\u011bn\u00edm. „S miniinvazivn\u00edmi p\u0159\u00edstupy je tak\u00e9 spojena v\u011bt\u0161\u00ed pravd\u011bpodobnost n\u00e1vratu \u00fapln\u00e9 kontinence. Robotick\u00fd syst\u00e9m da Vinci, kter\u00fd vyu\u017e\u00edv\u00e1me v Nemocnici sv. Zdislavy v Mosti\u0161t\u00edch, nab\u00edz\u00ed mo\u017enost dokonal\u00e9ho p\u0159ehledu v opera\u010dn\u00edm poli. Lze tak identifikovat velmi p\u0159esn\u011b oblast mo\u010dov\u00e9ho sv\u011bra\u010de i nervov\u00e9ho svazku, kter\u00fd je d\u016fle\u017eit\u00fd pro ztopo\u0159en\u00ed \u00fadu,“ shrnuje chirurg.<\/p>\n
Rychlej\u0161\u00ed rekonvalescence Roboticky prov\u00e1d\u011bn\u00e9 operace jsou miniinvazivn\u00ed, tedy \u0161etrn\u00e9. Pacienti zpravidla nemaj\u00ed b\u011bhem v\u00fdkonu ani v dal\u0161\u00edm obdob\u00ed ztr\u00e1tu krve. Maj\u00ed mal\u00e9 jizvy (asi 5 jizev velikosti kolem 1 cm), kter\u00e9 se v\u011bt\u0161inou velmi rychle a bez komplikac\u00ed hoj\u00ed. Bolestivost je tak\u00e9 sn\u00ed\u017eena a je neporovnateln\u011b men\u0161\u00ed ne\u017e u pacient\u016f s opera\u010dn\u00ed jizvou d\u00e9lky 30 a v\u00edce centimetr\u016f. \u0160etrn\u00fd opera\u010dn\u00ed p\u0159\u00edstup zkracuje tak\u00e9 dobu celkov\u00e9 rekonvalescence, tedy dobu, kdy\u017e je pacient v dom\u00e1c\u00edm l\u00e9\u010den\u00ed a chyst\u00e1 se nastoupit do pr\u00e1ce.<\/p>\n
Radik\u00e1ln\u00ed operace prostaty Rakovina prostaty pat\u0159\u00ed k v\u016fbec nej\u010dast\u011bj\u0161\u00edm n\u00e1dorov\u00fdm onemocn\u011bn\u00edm u mu\u017e\u016f. Na\u0161t\u011bst\u00ed je mo\u017en\u00e9 jim nab\u00eddnout modern\u00ed l\u00e9\u010dbu, kter\u00e1 jim dok\u00e1\u017ee v\u00fdrazn\u011b prodlou\u017eit \u017eivot. Je ale nezbytn\u00e9, aby byl n\u00e1dor odhalen \u010das, kdy\u017e je\u0161t\u011b nedo\u0161lo k jeho roz\u0161\u00ed\u0159en\u00ed do dal\u0161\u00edch tk\u00e1n\u00ed a org\u00e1n\u016f. V sou\u010dasnosti v\u011bt\u0161ina pacient\u016f podstupuje opera\u010dn\u00ed odstran\u011bn\u00ed prostaty, tzv. radik\u00e1ln\u00ed prostatektomii. „Radik\u00e1ln\u00ed operace prostaty se prov\u00e1d\u00ed u pacient\u016f, kte\u0159\u00ed nemaj\u00ed dal\u0161\u00ed z\u00e1va\u017en\u00e1 onemocn\u011bn\u00ed a u nich\u017e je p\u0159edpokl\u00e1dan\u00e1 d\u00e9lka do\u017eit\u00ed minim\u00e1ln\u011b deset let. C\u00edlem radik\u00e1ln\u00ed prostatektomie je odstran\u011bn\u00ed \u017el\u00e1zy posti\u017een\u00e9 n\u00e1dorem a \u00fapln\u00e9 vyl\u00e9\u010den\u00ed v p\u0159\u00edpad\u011b, \u017ee nemoc byla opravdu omezena jen na prostatu,“ popisuje prim\u00e1\u0159 Jaroslav Tvar\u016f\u017eek.<\/p>\n
<\/p>\n
Hospod\u00e1\u0159sk\u00e9 noviny<\/p>\n","protected":false},"excerpt":{"rendered":"
Nemocnice sv. Zdislavy v Mosti\u0161t\u00edch pat\u0159\u00ed mezi \u0161pi\u010dkov\u00e1 evropsk\u00e1 centra, kter\u00e1 nab\u00edz\u00ed sv\u00fdm pacient\u016fm specializovan\u00e9 operace pomoc\u00ed robotick\u00e9 chirurgie. Miniinvazivn\u011b se prov\u00e1d\u00ed celou \u0159adou v\u00fdkon\u016f, […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14511,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-26855","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26855","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26855"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/26855\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14511"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26855"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26855"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}