Schippers E, Schumpelick V
Chirurgische Klinik, Klinikum, RWTH Aachen.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:767-9.
The extended application of laparoscopic techniques led to complications related to the procedure (resection of wrong segments, non-curative resections, perforation, anastomotic stenosis/leakage). Main aetiology is the missing tactile sense. The combined action of laparoscopy and intraoperative endoluminal endoscopy is here an alternative. Intraoperative endoscopy is useful at the upper GI tract during total vagotomy, SPV, Taylor procedure, myotomy, fundoplication, perforated ulcer and BI/BII resections. During colorectal procedures, intraoperative endoscopy provides localisation of the tumor, determination of margins for resection, identification of anatomy (i.e. Hartmann stump) as well as inspection of the anastomoses. A consequent combination of intraabdominal and endoluminal endoscopy is helpful in prevention of the observed complications due to laparoscopic surgery.
腹腔镜技术的广泛应用导致了与该手术相关的并发症(切除错误节段、非根治性切除、穿孔、吻合口狭窄/渗漏)。主要病因是缺乏触觉。腹腔镜检查与术中腔内内镜检查的联合应用是一种替代方法。术中内镜在上消化道全迷走神经切断术、脾静脉离断术、泰勒手术、肌切开术、胃底折叠术、穿孔性溃疡及BI/BII切除术期间很有用。在结直肠手术中,术中内镜可用于肿瘤定位、确定切除边缘、识别解剖结构(如哈特曼残端)以及检查吻合口。腹腔内和腔内内镜的联合应用有助于预防腹腔镜手术中观察到的并发症。