Klemm B, Salm R
Department of Gynaecology and Obstetrics, Caritasklinik St. Theresia, Saarbruecken, Germany.
Endosc Surg Allied Technol. 1995 Feb;3(1):58-62.
The rapid increase in the number of endoscopic operations performed has resulted in a corresponding rise in the incidence of severe complications. This issue has generated widespread concern at recent congresses. It is now indisputable that safer access to the abdominal cavity is required. We have developed a technique of vacuum-supported visual access which allows the surgeon to anticipate dangerous sites of access and avoid injuries to internal organs or retroperitoneal blood vessels. The procedure has two major advantages: Firstly, a pre-peritoneal approach allows the surgeon to visualise the structures behind the peritoneum, and secondly, puncture of the insufflation-needle is facilitated and the depth of insertion is minimised. The underlying principle is to use negative pressure to elevate the peritoneum. Using this approach, the principles of open surgery are adhered to during abdominal access, thereby avoiding visceral injury.
内镜手术数量的迅速增加导致严重并发症的发生率相应上升。这个问题在最近的大会上引起了广泛关注。现在，需要更安全地进入腹腔这一点已无可争议。我们开发了一种真空辅助视觉进入技术，该技术使外科医生能够预先判断危险的进入部位，避免对内部器官或腹膜后血管造成损伤。该手术有两个主要优点：第一，经腹膜前入路使外科医生能够看清腹膜后的结构；第二，便于穿刺气腹针并将进针深度减至最小。其基本原理是利用负压提升腹膜。采用这种方法，在腹部进入过程中遵循开放手术的原则，从而避免内脏损伤。
