Dong Xiaoyu, Chen Xiaoyu, Zhu Yu, Liu Zixuan, Jiang Fengyue, Luo Jun, Yu Jiang, Li Guoxin, Zhao Liying
The First Clinical Medical School, Southern Medical University, Guangzhou 510515, China.
Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Aug 25;20(8):884-886.
To introduce the application and clinical effect of self-made liver fixing device in laparoscopic radical gastrectomy.
Clinical data of 469 patients underwent laparoscopic radical gastrectomy in Nanfang Hospital, Southern Medical University from March 2014 to January 2017 were analyzed retrospectively. In laparoscopic radical gastrectomy, self-made liver fixing device was used to expose surgical field covered by hepatic lobe in gastric lesser curvature and hepatic flexure of colon. Manufacture of the self-made liver fixing device: appropriate length of the catheter was cut according to the size of liver; the lotus suture needle with a thread was put through two catheters to connect them. Then the prepared liver fixing device was sent into abdominal cavity through a 12-mm Trocar hole with needle holder and was fixed on the free hepatic lateral hepatogastric ligament with hemo-lock. Finally the application effect of the liver fixing device was evaluated by reviewing the surgical videos.
A mean time of 40.3 seconds was required to complete liver fixing by using the self-made liver fixing device in laparoscopic radical gastrectomy and liver did not slip down in all the cases. Liver secondary manual fixing by assistants was 2 times averagely. Three cases had mild liver injury.
The self-made liver fixing device in laparoscopic radical gastrectomy is easy to operate and can effectively expose sufficient surgical field, with high security and convenient materials.
介绍自制肝脏固定装置在腹腔镜根治性胃切除术中的应用及临床效果。
回顾性分析2014年3月至2017年1月在南方医科大学南方医院行腹腔镜根治性胃切除术的469例患者的临床资料。在腹腔镜根治性胃切除术中,使用自制肝脏固定装置暴露胃小弯和结肠肝曲被肝叶覆盖的手术视野。自制肝脏固定装置的制作:根据肝脏大小裁剪合适长度的导管;将带线的莲花缝合针穿过两根导管以连接它们。然后将制备好的肝脏固定装置通过12毫米套管针孔与持针器一起送入腹腔,并用血管夹固定在游离的肝外侧肝胃韧带上。最后通过回顾手术视频评估肝脏固定装置的应用效果。
在腹腔镜根治性胃切除术中使用自制肝脏固定装置完成肝脏固定平均需要40.3秒,所有病例肝脏均未下滑。助手平均进行肝脏二次手动固定2次。3例出现轻度肝损伤。
自制肝脏固定装置在腹腔镜根治性胃切除术中操作简便,能有效暴露足够的手术视野,安全性高且取材方便。