Department of Gynecology and Gynecologic Oncology, Charité University, Berlin, Germany.
J Minim Invasive Gynecol. 2011 Jul-Aug;18(4):516-9. doi: 10.1016/j.jmig.2011.03.005.
Presented is a case report of laparoscopic repair of an external iliac artery injury using titanium Yasargil clamps and intracorporeal suture during lymphadenectomy. Yasargil clamps were introduced and placed, 1 distal and 1 proximal to the lesion. The vascular injury site was identified and repaired using intracorporeal sutures. Laparoscopic staging was completed successfully. No sign of thrombosis or vascular occlusion was detected. The patient was discharged on postoperative day 4 to receive adjuvant therapy. Laparotomy is the accepted way of managing major vascular injuries during laparoscopy. However, in controlled circumstances, with availability of Yasargil clamps and a surgeon experienced with intracorporeal suturing, immediate laparoscopic repair of major vascular injury is feasible and is a safe alternative to open surgical repair.
本文报告了一例在淋巴结切除术中使用钛 Yasargil 夹和腔内缝合进行腹腔镜修复髂外动脉损伤的病例。引入并放置 Yasargil 夹,位于病变的 1 个远端和 1 个近端。通过腔内缝合识别和修复血管损伤部位。腹腔镜分期成功完成。未发现血栓或血管阻塞的迹象。患者于术后第 4 天出院接受辅助治疗。在腹腔镜手术期间,剖腹手术是处理主要血管损伤的公认方法。然而,在可控的情况下,有 Yasargil 夹和熟练掌握腔内缝合技术的外科医生,对主要血管损伤进行即时腹腔镜修复是可行的,并且是开放手术修复的安全替代方法。