Chaffanjon P, Bainville E, Cinquin P, Sarrazin R
Service de chirurgie générale et thoracique, CHU de Grenoble, France.
Bull Cancer. 1995 Dec;82 Suppl 5:569s-572s.
Extraperitoneal pelvioscopy is a surgical endoscopy without insufflation which enables exploration of the extraperitoneal space in order to obtain biopsy specimens of adenopathies and tumors. 189 extraperitoneal endoscopy have been performed since 1976. When made through an iliac approach, the Extraperitoneal Endoscopy explores iliac and pelvic lymph nodes. It is an indication when checking the extension of uterine, prostatic and bladder cancers. Recently, a system of computerized assistance has been added to the initial method. Its aim is to guide the movements of the surgical tool when the indication is difficult: overweight patient, small tumors, risky tumoral environment. The basic principle is to show recalculated RMI or CT scan sections of the patient during the intervention, on which appear in real time the positions of the endoscope and that of the target to biopsy. The authors describe the technical ways of the method, the system of tridimensional localisation included in the operating room and the sort of interface given to the surgeon. In the future, the realisation of a simulator of intervention will allow diffusion and teaching of this intervention.
腹膜外盆腔镜检查是一种无需气腹的手术内镜检查，可用于探查腹膜外间隙，以获取淋巴结病和肿瘤的活检标本。自1976年以来已进行了189例腹膜外内镜检查。通过髂骨入路进行时，腹膜外内镜检查可探查髂骨和盆腔淋巴结。在检查子宫癌、前列腺癌和膀胱癌的扩散情况时，这是一种适应症。最近，在最初的方法中增加了计算机辅助系统。其目的是在适应症困难时（超重患者、小肿瘤、危险的肿瘤环境）指导手术工具的移动。基本原理是在干预过程中显示患者重新计算的RMI或CT扫描切片，上面实时显示内窥镜和活检目标的位置。作者描述了该方法的技术方式、手术室中包含的三维定位系统以及给外科医生的界面类型。未来，实现干预模拟器将有助于这种干预的推广和教学。
