用于肾上腺及肾上腺外肿瘤的免夹和免缝合腹腔镜手术。
Clipless and sutureless laparoscopic surgery for adrenal and extra-adrenal tumors.
作者信息
Misra Mahesh Chandra, Aggarwal Sandeep, Guleria Sandeep, Seenu Vulatheru, Bhalla Amar Pal
机构信息
Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
出版信息
JSLS. 2008 Jul-Sep;12(3):252-5.
BACKGROUND
Newer, energy-based devices like the ultrasonic coagulator (Harmonic Scalpel, Ethicon Endo-Surgery, Inc., Cincinnati, OH) and the LigaSure vessel-sealing system (Valleylab, Boulder, CO) are increasingly being used in advanced laparoscopic procedures. Use of these devices has resulted in shorter operative time, less blood loss, and lower conversion rates. We present our experience with these devices for laparoscopic removal of adrenal and extra-adrenal tumors.
METHODS
Ten patients with adrenal tumors and 4 with extra-adrenal tumors were operated on laparoscopically with the ultrasonic shears and LigaSure vessel-sealing system. The entire surgery was carried out using these energy-based devices without using any clips or sutures.
RESULTS
No conversions were necessary. None of the patients experienced any major intraoperative or postoperative bleeding. The mean size of the tumor was 6.2 cm (range, 3 to 8). The mean operative time was 123 minutes (range, 80 to 210), and the mean blood loss was 70 mL (range, 10 to 150). Histopathology revealed pheochromocytomas in 7 patients.
CONCLUSIONS
Use of the LigaSure vessel-sealing device along with ultrasonic shears for laparoscopic removal of adrenal and extra-adrenal tumors is safe and effective.
背景
新型的能量型器械，如超声止血刀（谐波手术刀，爱惜康内镜外科公司，俄亥俄州辛辛那提）和LigaSure血管闭合系统（威力实验室，科罗拉多州博尔德），越来越多地用于先进的腹腔镜手术。使用这些器械可缩短手术时间、减少失血并降低中转开腹率。我们介绍我们使用这些器械进行腹腔镜肾上腺及肾上腺外肿瘤切除术的经验。
方法
10例肾上腺肿瘤患者和4例肾上腺外肿瘤患者接受了腹腔镜超声刀和LigaSure血管闭合系统手术。整个手术均使用这些能量型器械完成，未使用任何钛夹或缝线。
结果
无需中转开腹。所有患者均未发生任何术中或术后大出血。肿瘤平均大小为6.2 cm（范围3至8 cm）。平均手术时间为123分钟（范围80至210分钟），平均失血量为70 mL（范围10至150 mL）。组织病理学检查显示7例患者为嗜铬细胞瘤。
结论
使用LigaSure血管闭合器械联合超声刀进行腹腔镜肾上腺及肾上腺外肿瘤切除术安全有效。
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