McDanald D Matt, Levine Ronald L, Pasic Resad
Tricounty OB/GYN, La Grange, KY 40292, USA.
Surg Laparosc Endosc Percutan Tech. 2005 Dec;15(6):325-7. doi: 10.1097/01.sle.0000191618.02145.89.
The use of the left upper quadrant technique in establishing a pneumoperitoneum during gynecologic laparoscopy was reviewed retrospectively in 267 patients who underwent gynecologic laparoscopy. The study population included all patients presenting to the University of Louisville Hospital outpatient surgery unit for laparoscopic gynecologic surgery from January 1994 to March 2002. Data sheets were prospectively compiled for each patient that included their demographics as well as the intraoperative insufflation technique used and the number of attempts necessary to achieve successful insufflation. All recognized complications associated with establishment of the pneumoperitoneum or insertion of the primary trocar were recorded. The database included 3314 patients of which 267 underwent insufflation via the left upper quadrant technique. Failure to achieve insufflation using this technique occurred in 4 patients (1.5%). There were no bowel or vessel injuries. Puncture of the left lobe of the liver occurred in 3 patients (1.12%). All injuries were managed without laparotomy, and the patients fully recovered without sequelae. The left upper quadrant entry technique is an effective means of establishing a pneumoperitoneum in patients undergoing gynecologic laparoscopic procedures.
回顾性分析了267例行妇科腹腔镜检查的患者在建立气腹时使用左上腹技术的情况。研究对象包括1994年1月至2002年3月在路易斯维尔大学医院门诊手术部接受腹腔镜妇科手术的所有患者。前瞻性地为每位患者编制了数据表，包括其人口统计学资料以及术中使用的充气技术和成功充气所需的尝试次数。记录了所有与建立气腹或插入主套管针相关的公认并发症。该数据库包括3314例患者，其中267例通过左上腹技术进行充气。4例患者（1.5%）使用该技术未能成功充气。未发生肠道或血管损伤。3例患者（1.12%）发生肝左叶穿刺。所有损伤均未行剖腹手术处理，患者完全康复，无后遗症。左上腹穿刺技术是在接受妇科腹腔镜手术的患者中建立气腹的有效方法。
