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伞状腹壁提拉装置在免气腹腹腔镜手术中应用的初步研究

Preliminary study on the application of an umbrella-like abdominal wall-lifting device in gasless laparoscopic surgery.

作者信息

Wu Dong-Bo, Yang Sheng-Fu, Geng Kui-Hua, Qin Su-Jiao, Bao Yan-Li, Chen Xiang, Zheng Guang-Ping

机构信息

Department of General Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning City, Guangxi Zhuang Autonomous Region, China.

出版信息

J Laparoendosc Adv Surg Tech A. 2013 Mar;23(3):246-9. doi: 10.1089/lap.2012.0381. Epub 2013 Feb 4.

Abstract

UNLABELLED

Abstract Background: In laparoscopic surgery with CO2 pneumoperitoneum, serious complications often occur for elderly patients and those who undergo long operations. These complications mainly include respiratory and circulatory system changes. In patients with tumors, release of free tumor cells into the abdominal cavity is believed to be possible. Gasless laparoscopic techniques can avoid these complications of CO2 pneumoperitoneum. Currently, the main shortcoming of gasless laparoscopic techniques is inadequate operative space. Because of this shortcoming, gasless techniques have not been widely applied in clinical practice.

MATERIALS AND METHODS

We herein describe a new technique of gasless laparoscopic cholecystectomy in pigs using a self-designed umbrella-like abdominal wall-lifting device. This device lifts up the anterior abdominal wall by opening the umbrella leaf in the abdominal cavity.

RESULTS

Five pigs underwent laparoscopic cholecystectomy using this technique. The operation times were 85, 40, 28, 21, and 24 minutes. The corresponding bleeding volumes were 11, 20, 5, 2, and 8 mL.

CONCLUSIONS

These preliminary outcomes suggest that the umbrella-like abdominal wall-lifting technique is safe and feasible in gasless laparoscopic surgery and can provide sufficient exposure of the operative field. Further study in the form of randomized controlled trials is needed to investigate the advantages of this new technique.

摘要

未标注

摘要 背景:在二氧化碳气腹腹腔镜手术中,老年患者和长时间手术患者常发生严重并发症。这些并发症主要包括呼吸和循环系统变化。对于肿瘤患者,游离肿瘤细胞进入腹腔被认为是可能的。免气腹腹腔镜技术可避免二氧化碳气腹的这些并发症。目前,免气腹腹腔镜技术的主要缺点是手术空间不足。由于这一缺点,免气腹技术尚未在临床实践中广泛应用。

材料与方法

我们在此描述一种在猪身上使用自行设计的伞状腹壁提升装置进行免气腹腹腔镜胆囊切除术的新技术。该装置通过在腹腔内打开伞叶来提升前腹壁。

结果

五只猪使用该技术进行了腹腔镜胆囊切除术。手术时间分别为85、40、28、21和24分钟。相应的出血量分别为11、20、5、2和8毫升。

结论

这些初步结果表明,伞状腹壁提升技术在免气腹腹腔镜手术中是安全可行的,并且可以提供足够的手术视野暴露。需要以随机对照试验的形式进行进一步研究,以探讨这项新技术的优势。

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