腹腔镜肝脏游离的吊索技术。
The Sling Technique for Laparoscopic Liver Mobilization.
机构信息
CarePoint Health, Hudson County, New Jersey, USA.
New Jersey Medical School, Newark, New Jersey, USA.
出版信息
JSLS. 2024 Apr-Jun;28(2). doi: 10.4293/JSLS.2024.00011.
BACKGROUND
As liver surgery continues to evolve, be it open, laparoscopic or robotic, it remains a procedure that can deteriorate in the blink of an eye. Liver surgery in patients with hepatoma is further complicated, as the vast majority have significant fibrosis, if not cirrhosis. Thus, parenchymal sparing resection is increasingly necessary. Effective and safe intracorporeal mobilization of the liver is essential for minimal access parenchymal-sparing and conventional resection.
METHODS
This retrospective review of over 150 cases performed provides a hands-on approach to laparoscopic hepatic mobilization with the use of an inexpensive technique using a 1" packing tape to "Sling" the liver in-order to divide the ligaments holding the liver in place and optimally position the liver for parenchymal transection.
RESULTS
Use of a 1" packing tape to "Sling" the liver intracorporeally is demonstrated to enable mobilization of the liver for tissue sparing non-anatomic, anatomic and major resections.
CONCLUSION
Use of a 1" packing tape to "Sling" the liver intracorporeally can facilitate mobilization for resection. Surgeons hoping to master minimal access resection should also be well versed in the use of laparoscopic ultrasound and liver transplant "Piggyback" technique.
背景
随着肝脏手术的不断发展，无论是开放性手术、腹腔镜手术还是机器人手术，它仍然是一种可能在眨眼间恶化的手术。肝癌患者的肝脏手术更加复杂，因为绝大多数患者都有明显的纤维化，如果不是肝硬化的话。因此，越来越有必要进行实质性保留切除术。有效和安全的肝脏腔内游离对于微创实质性保留和常规切除术至关重要。
方法
本回顾性研究对 150 多例手术进行了分析，提供了一种使用廉价技术的腹腔镜肝脏游离的实际方法，即使用 1 英寸的打包带“悬挂”肝脏，以分割固定肝脏的韧带，并将肝脏最佳地定位用于实质横断。
结果
使用 1 英寸的打包带“悬挂”肝脏在腔内容易地实现了肝脏的游离，以进行组织保留的非解剖、解剖和大切除术。
结论
使用 1 英寸的打包带“悬挂”肝脏可以促进肝脏的游离以进行切除。希望掌握微创切除的外科医生也应该熟练掌握腹腔镜超声和肝移植“背驮式”技术。
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