Menken F C
Fortschr Med. 1975 Dec 18;93(35-36):1773-4.
During the filling up of the pneumoperitoneum the needle can be put in the wrong direction and so blood vessels , intestinum or adhesions might be punctured. According to the authors procedure the abdominal wall is grasped by one hand or an instrument. This way the umbilicus is placed in the best position for the puncture with the Verresneedle or the trocar. Pulling with the left hand vertically the direction of the needle or trocar consequently will be parallel to the vertebral column. With this procedure, lesions of intestinum or vessels are practically impossible. In more than 4000 personally performed laparoscopies the author never saw adhesions in the region of the umbilicus except in two cases of cancer patients. If the intestinum is adherent to the umbilicus, as in the case of ileus, surgical measures are necessary.
在建立气腹过程中，穿刺针可能会被放置在错误的方向，从而可能会刺破血管、肠管或粘连组织。根据作者的操作方法，用一只手或器械抓住腹壁。这样，肚脐就处于使用Verres针或套管针进行穿刺的最佳位置。用左手垂直牵拉，穿刺针或套管针的方向就会与脊柱平行。采用这种操作方法，几乎不可能损伤肠管或血管。在作者亲自操作的4000多例腹腔镜手术中，除了两例癌症患者外，从未在肚脐区域看到粘连。如果肠管与肚脐粘连，如肠梗阻的情况，则需要采取手术措施。
