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一种用于腹腔镜手术中应用纤维蛋白胶的新型非气体内喷雾装置。

A Novel Non-Gas Endospray for Applying Fibrin Glue in Laparoscopic Surgery.

作者信息

Tsutsumi Norifumi, Sakaguchi Yoshihisa, Kusumoto Tetsuya, Ikejiri Koji, Tsutsumi Ryosuke, Kimura Koichi, Maekawa Soichiro

机构信息

Department of Surgery, Center for Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.

Department of Surgery, Munakata Medical Association Hospital, Fukuoka, Japan.

出版信息

J Invest Surg. 2020 Apr;33(4):359-364. doi: 10.1080/08941939.2018.1519050. Epub 2018 Oct 31.

Abstract

: Fibrin glue and polyglycolic acid felt are used for tissue repair in various surgical procedures. However, using a spray device to apply fibrin sealant during laparoscopic surgery can increase the intraperitoneal pressure, which can cause complications such as air embolism. We developed a novel non-gas endospray for use in laparoscopic surgery. This study aimed to evaluate the sealing effect of this non-gas endospray in comparison with a conventional gas-spray device and to evaluate the safety of its application in the clinical setting. : An pressure test model was used to assess the sealing effect of the non-gas endospray (method 1) versus conventional gas-spray (method 2). A bottle was sealed with a rabbit skin sample that had been pierced nine times by a 19G needle. Each skin sample was sealed using either method 1 or method 2 ( = 10 for each method). The non-gas endospray was then used in two patients undergoing laparoscopic splenectomy with CO pneumoperitoneum. Intra-abdominal pressure was measured throughout the surgery. : Bursting pressures were similar in method 1 (246.9 ± 123.2 mmHg) and method 2 (265.5 ± 93.6 mmHg;  = 0.7082). During laparoscopic splenectomy, the non-gas endospray was successfully used to apply fibrin glue without any increase in intra-abdominal pressure. : The novel non-gas endospray produced a strong sealing effect similar to that of a conventional gas-spray device and has thus far proved feasible in the clinical setting.

摘要

纤维蛋白胶和聚乙醇酸毡用于各种外科手术中的组织修复。然而,在腹腔镜手术中使用喷雾装置施加纤维蛋白密封剂会增加腹腔内压力,这可能导致空气栓塞等并发症。我们开发了一种用于腹腔镜手术的新型非气体内镜喷雾器。本研究旨在评估这种非气体内镜喷雾器与传统气体喷雾装置相比的密封效果,并评估其在临床应用中的安全性。使用压力测试模型评估非气体内镜喷雾器(方法1)与传统气体喷雾(方法2)的密封效果。用一块被19G针头穿刺9次的兔皮样本密封一个瓶子。每个皮肤样本使用方法1或方法2进行密封(每种方法n = 10)。然后,在两名接受腹腔镜脾切除术并建立二氧化碳气腹的患者中使用非气体内镜喷雾器。在整个手术过程中测量腹腔内压力。方法1的破裂压力(246.9±123.2 mmHg)与方法2的破裂压力(265.5±93.6 mmHg;P = 0.7082)相似。在腹腔镜脾切除术中,非气体内镜喷雾器成功用于施加纤维蛋白胶,且腹腔内压力没有任何增加。这种新型非气体内镜喷雾器产生的密封效果与传统气体喷雾装置相似,并且迄今为止在临床环境中已证明是可行的。

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