Yoshida T, Inoue H, Iwai T
First Department of Surgery, Tokyo Medical and Dental University, Japan.
Surg Laparosc Endosc Percutan Tech. 2000 Dec;10(6):396-400.
The authors present an alteration at the site of a minilaparotomy in the abdominal phase of endoscopic esophagectomy and reconstruction by means of hand-assisted laparoscopic surgery. In the first case, a minilaparotomy was performed in the lower right side of the abdomen during laparoscopic construction of a gastric tube using hand-assisted laparoscopic surgery. However, this technique was not always feasible because an elaborate technique was necessary, even with the use of the surgeon's hand, which was inserted in the abdomen through the mini-incision. After the second case, the authors performed a minilaparotomy slightly above the stomach. The upper abdominal incision allowed easier and safer management of the gastric tube. This technique was also helpful in the Kocher maneuver and in the construction of the retrosternal route. The site of the minilaparotomy in the upper abdomen reduced the stress of this procedure, and, therefore, became the standard procedure for select patients at the First Department of Surgery, Tokyo Medical and Dental University.
作者介绍了在通过手辅助腹腔镜手术进行内镜食管切除术及重建的腹部阶段，迷你剖腹术部位的一种改变。在第一例中，在手辅助腹腔镜手术构建胃管的腹腔镜操作过程中，在腹部右下方进行了迷你剖腹术。然而，这种技术并非总是可行，因为即使使用通过小切口插入腹腔的术者手部，也需要精细的操作技术。在第二例之后，作者在胃上方稍高处进行了迷你剖腹术。上腹部切口使胃管的处理更加容易和安全。该技术在 Kocher 手法及胸骨后路径构建中也很有帮助。上腹部迷你剖腹术的部位减轻了该手术的压力，因此成为东京医科齿科大学第一外科部分患者的标准手术方式。
