Naitoh T, Gagner M
Department of General Surgery/A-80, Cleveland Clinic Foundation, OH 44195, USA.
Surg Endosc. 1997 Aug;11(8):830-3. doi: 10.1007/s004649900464.
Laparoscopic surgery has been successfully applied to several gastrointestinal procedures. Although the totally laparoscopic gastrectomy is feasible, tactile sensation and manipulation of the organ as well as the lesion are decreased when compared to open surgery. The Dexterity Pneumo Sleeve is a new device which allows the surgeon to insert a hand into the abdominal cavity while preserving the pneumoperitoneum. This device was used for patients who underwent laparoscopic gastric surgery.
The first patient presented with a non-Hodgkin's lymphoma of the stomach. A laparoscopically assisted distal gastrectomy was performed with Roux-en-Y reconstruction. The second patient had a 5-cm leiomyoma involving the greater curve of the stomach, and this device was used for manipulation of the tumor. The last patient suffered from morbid obesity with its associated medical complications and a ventral hernia. The Sleeve was applied at the hernia site and a laparoscopically assisted gastric bypass was performed.
The Pneumo Sleeve was useful in these cases for tactile localization of the tumor and for retraction and manipulation of the stomach and surrounding upper abdominal organs.
The utilization of this device resulted in a more easily performed dissection, resection, and anastomosis and was felt to decrease operation time.
腹腔镜手术已成功应用于多种胃肠道手术。尽管全腹腔镜胃切除术是可行的,但与开放手术相比,对器官及病变的触觉感知和操作能力会有所下降。灵巧气腹袖套是一种新型设备,可使外科医生在保持气腹的同时将手插入腹腔。该设备用于接受腹腔镜胃手术的患者。
首例患者为胃非霍奇金淋巴瘤。行腹腔镜辅助远端胃切除术并 Roux-en-Y 重建。第二例患者胃大弯处有一个 5 厘米的平滑肌瘤,使用该设备操作肿瘤。最后一例患者患有病态肥胖及其相关的医学并发症和腹疝。在疝部位应用袖套并进行腹腔镜辅助胃旁路手术。
气腹袖套在这些病例中有助于肿瘤的触觉定位以及胃和上腹部周围器官的牵拉和操作。
该设备的使用使解剖、切除和吻合操作更容易进行,并被认为可缩短手术时间。