摘要
目的 探讨免装置手助腹腔镜肝切除的可行性。 方法 选择位于肝第Ⅴ、Ⅳ、左外叶的原发性肝癌 5例 ,肝海绵状血管瘤 2例 ,肝局灶性增生结节 1例 ,建立操作装置后取上腹部肋缘下斜切口 ,切口长度与术者腕部相同 ,从切口处直接将术者的左手伸入腹腔 (无hand -port或蓝碟等装置 ) ,利用术者左手协同右手器械游离肝周韧带 ,切断肝脏 ,处理肝断面 ,实施腹腔镜肝切除。 结果 8例均成功地实施腹腔镜肝切除。手术时间 90～ 180min ,平均 118min。术中出血量 5 0～ 30 0ml,平均 16 0ml,无一例发生不能控制的出血 ,无一例发生并发症。 结论 免装置手助的方法实施腹腔镜肝切除同样达到手辅助的目的 ,安全、可行。
Objective To investigate the feasibility of hand-assisted laparoscopic liver resection without hand-port devices. Methods Eight patients were selected into the study, including 5 cases of primary liver cancer located at the segment Ⅳ or Ⅴ or the left lateral lobe, 2 cases of liver spongy hemangioma and 1 case of hepatic focal nodular hyperplasia. After the laparoscopic devices were set up, an oblique incision below the right costal margin was made. The length of the incision was the same as the operator’s wrist. In the absence of hand-port or “blue disc”, the operator’s left hand directly entered the abdominal cavity through the incision. With the assistance of operator’s left hand, the laparoscopic liver resection was conducted, with the ligaments surrounding the liver dissociated, the liver transected and the cut surface properly managed. Results Laparoscopic liver resection was performed successfully in all the 8 patients. The operation time ranged 90～180 min (mean, 118 min), and the blood loss was 50～ 300 ml (mean, 160 ml). There was no uncontrolled bleeding during the operation and no complication happened. Conclusions Hand-assisted laparoscopic liver resection without hand-port devices is a safe and feasible procedure. It may not only reach the purpose of hand assistance but also lower the surgical costs.
出处
《中国微创外科杂志》
CSCD
2005年第1期25-26,共2页
Chinese Journal of Minimally Invasive Surgery
基金
广东省重点攻关项目基金资助 (编号 :99B0 670 1G)
关键词
腹腔镜
肝切除
手助腹腔镜
Laparoscopy
Liver resection
Hand-assisted laparoscopy
