Cohen Ricardo Vitor, Schiavon Carlos Aurélio, Pinheiro Filho José Carlos, Correa José Luis Lopes
The Center for the Surgical Treatment of Morbid Obesity, Hospital São Camilo, São Paulo, SP, Brazil.
Rev Hosp Clin Fac Med Sao Paulo. 2003 Sep-Oct;58(5):I-VIII.
Obesity is an endemic disease. It was already proved that the clinical approach to morbid obesity fails in 95% of cases. Laparoscopy has shown that is related to a milder metabolic response and a smoother postoperative period. There is no doubt that the laparoscopic approach is not the future for the surgical treatment of morbid obesity, but the best present approach and with equally excellent results when compared to the traditional open operation. However, this challenging surgery requires masterful use of an array of specialized laparoscopic equipment and instrumentation. These include proper video monitors, cameras, visualization, peritoneal entrance, scopes, cutting/coagulation equipments, and staplers, suturing devices, graspers, dedicated endosurgery operating rooms, robotics and awareness of newer equipment. This paper covers the benefits of the laparoscopic access in bariatric surgery and reviews the cutting-edge in technology to drive surgeons and patients to a smoother intra and postoperative course.
肥胖是一种流行病。已经证实,针对病态肥胖的临床治疗方法在95%的病例中都失败了。腹腔镜检查表明,它与较轻的代谢反应和更平稳的术后恢复有关。毫无疑问,腹腔镜手术方法并非病态肥胖外科治疗的未来,但却是目前最好的方法,与传统开放手术相比,效果同样出色。然而,这种具有挑战性的手术需要熟练使用一系列专门的腹腔镜设备和器械。这些包括合适的视频监视器、摄像头、可视化设备、腹膜入口器械、内窥镜、切割/凝血设备、吻合器、缝合装置、抓钳、专用的内镜手术室、机器人技术以及对更新设备的了解。本文阐述了腹腔镜手术入路在减肥手术中的益处,并综述了前沿技术,以使外科医生和患者获得更平稳的术中及术后过程。