Ntourakis Dimitrios, Marescaux Jacques, Pessaux Patrick
Digestive and Endocrine Surgery, Nouvel Hopital Civil, University of Strasbourg, 67000, Strabourg, France,
World J Surg. 2015 Jan;39(1):292-6. doi: 10.1007/s00268-014-2784-8.
Laparoscopic hepatobiliary surgery, although technically demanding, gains popularity due to the patient benefits of a mini-invasive approach. Laparoscopic distal pancreatectomy is a technically feasible and reproducible operation that doesn't require complex digestive reconstruction. It requires advanced laparoscopic skill for vascular dissection and control. Due to the absence of trials proving its oncological results it is mainly indicated for benign or borderline tumours of the pancreatic body and tail. Since for these tumours there is no indication for a lymph node dissection, there are benefits for the patient if the spleen is preserved. There is some evidence that robotic assistance facilitates the procedure and makes it accessible to surgeons diminishing the necessity of advanced laparoscopic skills. In this technical multimedia article, we present our method for a robotic mini-invasive spleen preserving distal pancreatectomy with preservation of the splenic vessels. The technique is presented in a stepwise approach with an accompanying video. We believe that the use of the Da Vinci robotic platform facilitates this demanding procedure.
腹腔镜肝胆手术虽然技术要求高，但因其微创方法给患者带来的益处而越来越受欢迎。腹腔镜远端胰腺切除术是一种技术上可行且可重复的手术，不需要复杂的消化重建。它需要先进的腹腔镜技术来进行血管解剖和控制。由于缺乏试验证明其肿瘤学结果，它主要适用于胰体和胰尾的良性或交界性肿瘤。由于这些肿瘤没有进行淋巴结清扫的指征，如果保留脾脏对患者有益。有一些证据表明，机器人辅助有助于该手术的进行，并使外科医生更容易开展，减少了对先进腹腔镜技术的需求。在这篇技术多媒体文章中，我们展示了我们保留脾脏血管的机器人微创保留脾脏远端胰腺切除术的方法。该技术以逐步的方式呈现，并配有视频。我们相信达芬奇机器人平台的使用有助于完成这一高要求的手术。
