Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
J Am Coll Surg. 2020 Nov;231(5):e8-e10. doi: 10.1016/j.jamcollsurg.2020.06.025. Epub 2020 Aug 14.
Minimally invasive surgery techniques have evolved remarkably over the past few decades in the field of surgical oncology, including nascent techniques for pancreatic malignancies. The emergence of the robotic surgery platform has accelerated widespread implementation of minimally invasive pancreatectomy. However, whether minimally invasive approaches can maintain the quality of oncologic surgical procedures, particularly in superior mesenteric artery (SMA) dissection during pancreatoduodenectomy, remains unknown. We developed external retraction techniques to mitigate the limitations of the robotic surgery platform and help maintain the quality of oncologic resection. Specifically, vessel loops encircling the superior mesenteric vein are ligated with Endoloops, and the ends of the Endoloops are carefully retracted externally on the patient’s left side. This maneuver provides critical exposure of the SMA that allows safe, high-quality oncologic dissection. We describe our external retraction techniques in the video presentation, which can improve the safety and quality of robotic pancreatoduodenectomy.
在过去几十年的外科肿瘤学领域中，微创外科技术取得了显著的发展，包括新兴的胰腺恶性肿瘤技术。机器人手术平台的出现加速了微创胰腺切除术的广泛实施。然而，微创方法是否能够保持肿瘤外科手术的质量，特别是在胰十二指肠切除术期间肠系膜上动脉（SMA）解剖中，仍然未知。我们开发了外部牵引技术来减轻机器人手术平台的限制，并帮助维持肿瘤切除的质量。具体来说，用 Endoloops 结扎环绕肠系膜上静脉的血管环，然后小心地将 Endoloops 的末端从患者的左侧向外牵拉。这一操作提供了 SMA 的关键暴露，从而实现了安全、高质量的肿瘤学解剖。我们在视频演示中描述了我们的外部牵引技术，这些技术可以提高机器人胰十二指肠切除术的安全性和质量。
