Usui Shinsuke, Ito Koji, Hiranuma Susumu, Takiguchi Noriaki, Matsumoto Akio, Iwai Takehisa
Department of Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, Japan.
Surg Laparosc Endosc Percutan Tech. 2007 Apr;17(2):107-10. doi: 10.1097/SLE.0b013e318030acd6.
Although there are several reports on the esophagojejunostomy during laparoscopy-assisted total gastrectomy, the procedures still remain to be established. We report hand-assisted laparoscopic esophagojejunostomy using circular stapler and newly developed instrument "Endo-PSI." Between April 2005 and April 2006, 13 patients received these products during laparoscopy-assisted total gastrectomy. The Endo-PSI was attached to the abdominal esophagus using hand-assisted laparoscopic surgery. The insertion of the straight needle with 2-0 polypropylene into the device and the cutting of the esophagus were also performed using hand-assisted laparoscopic surgery. The insertion of the anvil head into the esophagus and the ligation of the purse-string suture were performed laparoscopically. After the jejuno-jejunal anastomosis was performed extracorporeally, the combination of the circular stapler for esophagojejunostomy and the closure of the stump of the jejunum were performed laparoscopically. There were no complications attributable to this procedure and there were no cases that required conversion to conventional open procedure or required extension of median incision. This newly developed Endo-PSI was useful for laparoscopic purse-string suture.
尽管有几篇关于腹腔镜辅助全胃切除术中食管空肠吻合术的报道，但该手术方法仍有待完善。我们报告了使用圆形吻合器和新开发的器械“Endo-PSI”进行手辅助腹腔镜食管空肠吻合术的情况。2005年4月至2006年4月期间，13例患者在腹腔镜辅助全胃切除术中使用了这些产品。通过手辅助腹腔镜手术将Endo-PSI附着于腹段食管。使用手辅助腹腔镜手术将带2-0聚丙烯的直针插入该装置并切断食管。在腹腔镜下将钉砧头插入食管并结扎荷包缝线。在体外进行空肠-空肠吻合后，在腹腔镜下进行食管空肠吻合的圆形吻合器操作及空肠残端的闭合。该手术未出现并发症，也没有病例需要转为传统开放手术或延长正中切口。这种新开发的Endo-PSI对腹腔镜荷包缝合很有用。
