Hiki Naoki, Fukunaga Tetsu, Yamaguchi Toshiharu, Nunobe Souya, Ohyama Shigekazu, Tokunaga Masanori, Miki Akira, Kuroyanagi Hiroya, Seto Yasuyuki, Muto Tetsuichiro
Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Surg Technol Int. 2008;17:121-5.
Laparoscopic surgery is increasingly applied to the treatment of gastrointestinal disease. However, the insertion of secondary trocars following pneumoperitoneum carries the risk of serious complications such as major vascular and bowel injuries. Such injury can arise when the force required for the trocar insertion is such that it causes the operator to have impaired control over the entry. There is a need for a procedure of secondary trocar insertion that is safe and easy to perform for training clinicians in laparoscopic surgery. We have developed the "cut-and-screw" insertion method for secondary trocar insertion using a specially developed laparoscopic cannula with a sharp edge and housing. Our procedure is simple, rapid, and safe. In this chapter, we describe the technique and present our initial clinical results.
腹腔镜手术越来越多地应用于胃肠道疾病的治疗。然而，气腹后插入辅助套管针存在严重并发症的风险，如主要血管和肠道损伤。当插入套管针所需的力量导致操作者对进入的控制受损时，就可能发生这种损伤。对于培训腹腔镜手术临床医生而言，需要一种安全且易于操作的辅助套管针插入方法。我们开发了一种“切割-旋拧”插入方法，用于使用专门开发的带有锋利边缘和套管的腹腔镜套管进行辅助套管针插入。我们的方法简单、快速且安全。在本章中，我们描述了该技术并展示了我们的初步临床结果。
