Departments of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan.
J Minim Invasive Gynecol. 2011 Jul-Aug;18(4):507-11. doi: 10.1016/j.jmig.2011.04.012.
Because it is minimally invasive, laparoscopic surgery is preferred over open surgery. However, it is often difficult to maintain an adequate surgical field during the procedure. As in open laparotomy, securing an adequate surgical field is important for adequate visualization. We evaluated the effectiveness and safety of the Endoractor, an organ retraction sponge that can be inserted through a 12-mm trocar to secure a surgical field in gynecologic laparoscopic surgery. The Endoractor, a 100% cellulose compressed sponge, can be expanded using physiologic saline solution, with the result that the swollen sponge displaces organs away from the surgical field. Between October 2009 and April 2010, we used the Endoractor in 24 patients, placed in a Trendelenberg position, during laparoscopic surgery. In no patients, even with return to a horizontal position, did the intestines fall into the pelvis, and surgery was easily performed. Mean (SD; 95% CI) operative time was 92.7 (44.5; 74.0-111.6) minutes, and blood loss was 54.1 (73.1; 22.9-82.1) mL. All patients were discharged on postoperative day 3. Even with the patient in a horizontal position without use of the Trendelenberg position, the Endoractor enables a good surgical field to be secured. It remains to be seen whether this device works as well in obese patients.
由于微创手术具有微创性，因此优于开放性手术。然而，在手术过程中，通常很难保持足够的手术视野。与开放性剖腹手术一样，确保足够的手术视野对于充分的可视化非常重要。我们评估了一种名为 Endoractor 的器官牵引海绵的有效性和安全性，该海绵可通过 12mm 的 trocar 插入以固定妇科腹腔镜手术中的手术视野。Endoractor 是一种 100%纤维素压缩海绵，可使用生理盐水溶液扩张，肿胀的海绵将器官从手术视野中推开。在 2009 年 10 月至 2010 年 4 月期间，我们在 24 名患者中使用了 Endoractor，这些患者处于头高脚低位，进行腹腔镜手术。在没有患者（即使在恢复到水平位置后）的情况下，肠子掉入骨盆，手术很容易进行。平均（SD；95%CI）手术时间为 92.7（44.5；74.0-111.6）分钟，出血量为 54.1（73.1；22.9-82.1）mL。所有患者均在术后第 3 天出院。即使患者处于水平位置且未使用头高脚低位，Endoractor 也能确保获得良好的手术视野。该设备在肥胖患者中的效果如何还有待观察。
