Fowler D L, White S A
Olathe Medical Center, Kansas.
Surg Laparosc Endosc. 1991 Sep;1(3):183-8.
Laparoscopic cholecystectomy has been widely accepted, and because of its many benefits, other intra-abdominal operations are now being done laparoscopically. We felt the next step in the evolution of laparoscopic surgery could be bowel resection. This paper presents two cases of laparoscopic sigmoid resection and a detailed description of the technique. Included in the technique is the use of prototype endoscopic stapling devices to divide the mesentery and bowel. The two most difficult technical decisions involved the methods for specimen removal and for completing the anastomosis. The specimen was removed through a muscle splitting incision in the left lower quadrant, positioned as a mirror image of a standard appendectomy incision. The anvil of the CEEA (end-to-end) stapler was also position in the proximal colon through this incision; the anastomosis was completed with the CEEA stapler.
腹腔镜胆囊切除术已被广泛接受，由于其诸多优点，现在其他腹腔内手术也在通过腹腔镜进行。我们认为腹腔镜手术发展的下一步可能是肠切除术。本文介绍了两例腹腔镜乙状结肠切除术及该技术的详细描述。该技术包括使用原型内镜吻合器来分离肠系膜和肠管。两个最困难的技术决策涉及标本取出方法和完成吻合的方法。标本通过左下腹的肌肉劈开切口取出，该切口的位置与标准阑尾切除术切口呈镜像。CEEA（端端）吻合器的钉砧也通过该切口置于近端结肠；用CEEA吻合器完成吻合。
