Fujikawa Takahisa, Kajiwara Masatoshi
Surgery, Kokura Memorial Hospital, Kitakyushu, JPN.
Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
Cureus. 2022 Mar 27;14(3):e23528. doi: 10.7759/cureus.23528. eCollection 2022 Mar.
While minimizing intraoperative blood loss during liver resection is one of the most important tasks, it is more difficult to control the refractory bleeding during laparoscopic liver resection than with an open approach. We herein provide a modification of the two-surgeon technique that enables laparoscopic liver parenchymal transection to be performed as quickly and securely as open liver resection. To achieve proper "role sharing," the "transection mode" and the "hemostatic mode" are independent sets in place in this procedure, and these modes are switched rigidly according to the surgical field condition. By thoroughly sharing the roles, rapid laparoscopic liver parenchymal transection comparable to open liver resection can be accomplished. The present modified approach achieves satisfactory transection and hemostasis of the liver parenchyma and is also advantageous for teaching young surgeons and the entire surgical team.
虽然在肝切除术中尽量减少术中失血是最重要的任务之一，但与开放手术相比，腹腔镜肝切除术中控制难治性出血更加困难。我们在此提供了一种双术者技术的改良方法，该方法能够使腹腔镜肝实质离断术像开放肝切除术一样快速、安全地进行。为了实现恰当的“角色分担”，在此手术过程中，“离断模式”和“止血模式”是独立设定的，并且这些模式会根据手术视野情况严格切换。通过充分分担角色，可以完成与开放肝切除术相当的快速腹腔镜肝实质离断术。目前的改良方法实现了肝实质的满意离断和止血，并且对于年轻外科医生和整个手术团队的教学也具有优势。
