Partecke Lars Ivo, Kessler Wolfram, Patrzyk Maciej, Heidecke Claus-Dieter, Bernstorff Wolfram V
Board Certified Surgeon,Department of General, Visceral, Thoracic, and Vascular Surgery, University Medicine, Greifswald, Germany.
Medical Sub-Director. Department of General, Visceral, Thoracic, and Vascular Surgery, University Medicine, Greifswald, Germany.
Surg Technol Int. 2011 Dec;21:85-91.
In view of the fact that appendectomy is the most common operation for an acute abdomen, laparoscopic appendectomy has evolved as the most frequently performed procedure. Hospitals, therefore, require at all times the expertise, technique, and staff to ensure a high quality of standard for appendectomies, which not only supports the requirements of the high caseload but also takes into consideration the socio-economical aspects. A critical step is the closure of the appendicular stump. The three most widely employed techniques are an endo-stapler, an endo-loop, or a clip. Although the endo-stapler is fairly expensive, it combines closing and transecting the appendix in one step, offers the possibility of a partial caecal resection, and can be used if the appendicular base is inflamed. Endo-loop and clip are equally cost-effective, but the clip appears to be simpler in handling than the endo-loop and, like the stapler, offers closing and cutting the appendix before dissecting the mesoappendix. However, only appendices up to 16 mm in diameter can be clipped, a disadvantage not shared with the loop.
鉴于阑尾切除术是急腹症最常见的手术，腹腔镜阑尾切除术已发展成为最常施行的手术。因此，医院始终需要专业知识、技术和人员，以确保阑尾切除术的高质量标准，这不仅要满足高病例量的需求，还要考虑社会经济方面。一个关键步骤是阑尾残端的闭合。三种应用最广泛的技术是内镜吻合器、内镜圈套器或夹子。尽管内镜吻合器相当昂贵，但它能在一步操作中完成阑尾的闭合和横断，提供了部分盲肠切除的可能性，并且在阑尾根部发炎时也可使用。内镜圈套器和夹子具有同样的成本效益，但夹子在操作上似乎比内镜圈套器更简单，并且与吻合器一样，在解剖阑尾系膜之前就能完成阑尾的闭合和切断。然而，直径达16毫米的阑尾才能用夹子处理，这是圈套器所没有的一个缺点。
