中文摘要：

目的：完善相关术前评估并取得患者知情同意后,国内首次尝试进行机器人单孔腹腔镜肾上腺肿瘤切除术,探讨该手术的可行性和安全性,总结操作经验。方法：我院于2017年5月8日及5月9日先后完成单孔多通道（Single-siteTMPort）机器人辅助腹腔镜肾上腺肿瘤切除术2例。患者性别、年龄（岁）、BMI（kg/m2）、ASA评分、Charlson合并症指数（Age-weighted）、肿瘤侧别、肿瘤最大径（cm）、术前血醛固酮水平（ng/dl）、肾素水平（pg/ml）分别为男性/男性、55/38、26.3/22.7、Ⅱ/Ⅱ、0/0、左/双、1.5/1.8、30.2/33.1、1.52/2.17。于左锁骨中线肋缘下4cm处取一2~3cm纵形皮肤切口,打开左侧结肠旁沟,将降结肠翻至内侧,打开脾结肠韧带及脾肾韧带,将脾脏、胰尾推向右侧,打开左肾周筋膜,寻及肾上腺肿瘤,Hem-o-lok夹闭并离断与肿瘤相连的正常肾上腺组织,完整切除肿瘤。结果：2例手术均顺利完成,手术时间、术中出血、切口长度分别为111/106min、20/50ml、3.9/3.8cm;未发生任何术中并发症。术后第1、2、3天患者视觉疼痛模拟评分分别为3/4、2/1、1/-;术后禁食时间、引流管留置时间、术后住院时间分别为0.5/0.5d、8/1d、9/2d;1例患者术后出现肺部感染,予以对症处理后顺利出院。出院前患者血压均恢复正常。病理学结果提示2例均为肾上腺皮质腺瘤。结论：初步经验表明单孔多通道机器人辅助腹腔镜肾上腺肿瘤切除术安全、可行、有效,术后患者疼痛轻,恢复快,切口小,短期疗效确切,但需严格把握临床适应证。

英文摘要：

Objective：To present the first clinical case series of robotic laparoendoscopic single-site（LESS）adrenalectomy in the mainland of China and assess its safety and feasibility.Method：Two patients underwent robotic LESS adrenalectomy by a single urologic surgical team at 8th May 2017 and 9th May respectively in our institution.These two patients＇ demographics and tumor characteristics,including age,gender,body mass index（kg/m2）,Charlson Co-morbidity Index（Age-weighted）,tumor laterality,diameter（cm）were：55/38,male/male,26.3/22.7,0/0,left/bilateral,1.5/1.8respectively.A 2-3cm longitudinal skin incision was made at 4cm below the inferior margin of rib arch at the level of midaxillary line.The line of Toldt was incised with the descending colon medially mobilized.The lienorenal and splenocolic ligaments were divided.The spleen and pancreatic tail were carefully separated.Gerota＇s fascia was opened,the normal adrenal tissue associated with the tumor was clamped with hem-o-locks and disrupted,and the adrenal mass was sufficiently dissected and removed entirely.Result：The two procedures were smoothly completed without any extra skin incision or intraoperative complications.Operative duration,estimated blood loss and skin incision length was respectively 111/106 min,20/50 ml,3.9/3.8cm.Postoperative pain measured by the visual analog pain scale（VASP）at day 1,day 2,day 3was 3/4,2/1,1/-.Time off oral intake,duration of drainage and length of stay after surgery was 0.5/0.5d,8/1d,9/2d,respectively.One patient developed pulmonary infection and was treated with anti-infective measures and discharged smoothly.The blood pressure of both patients returned to normal at discharge and their pathologic outcomes were both adrenal cortical adenoma.Conclusion：The initial experience shows the robotic LESS adrenalectomy is a safe,feasible and efficacious procedure.It exhibits clinical benefits for patients in terms of pain control,convalescence and cosmesis,but the clinical indications should be strictly cont