Seshadri P A, Poulin E C, Mamazza J, Schlachta C M
University of Toronto Centre for Minimally Invasive Surgery, St. Michael's Hospital, Ont.
Can J Surg. 2000 Aug;43(4):303-5.
As technology advances, the techniques of laparoscopic surgery are being refined and their application is expanding to include many disease processes and organs. The new-generation laparoscopic instruments are becoming smaller (less than 5 mm). Expected advantages include improvements in cosmesis and patient satisfaction, and decreased postoperative analgesic requirements. Non-neoplastic cysts of the spleen are rare, and their management has evolved from total open splenectomy to laparoscopic cyst decapsulation. A 22-year-old woman with a symptomatic 10-cm epithelial cyst was treated by splenic decapsulation with needlescopic instruments (3 mm or smaller). Three trocars were used: one 12-mm umbilical and two 3-mm subcostal ports. The cyst was punctured by a Veress needle, and after drainage of straw-coloured fluid, circumferential decapsulation with 5-mm laparoscopic shears through the umbilical port site was done. The patient was discharged within 24 hours, having had a single intramuscular injection of meperidine and an excellent cosmetic result.
随着技术的进步，腹腔镜手术技术不断完善，其应用范围也在扩大，涵盖了许多疾病过程和器官。新一代腹腔镜器械正变得越来越小（小于5毫米）。预期的优势包括美容效果改善、患者满意度提高以及术后镇痛需求减少。脾脏的非肿瘤性囊肿很少见，其治疗方法已从完全开放性脾切除术发展为腹腔镜囊肿去顶术。一名22岁有症状的10厘米上皮囊肿女性患者接受了针式腹腔镜器械（3毫米或更小）的脾脏去顶术治疗。使用了三个套管针：一个12毫米的脐部套管针和两个3毫米的肋下套管针。用韦雷氏针穿刺囊肿，抽出淡黄色液体后，通过脐部套管针部位用5毫米腹腔镜剪刀进行环形去顶。患者在单次肌内注射哌替啶后24小时内出院，美容效果极佳。
