后腹腔镜肾切除术快速寻找肾血管的方法

Quickly ideatifying renal vessels during laparoscopic nephrectomy

目的：探讨后腹腔镜肾切除术中快速寻找肾动静脉的方法。方法：回顾性分析2003年10月～2006年6月施行的后腹腔镜下根治性肾切除及单纯性肾切除术150例，术中按照位置、牵拉、隆起、搏动、纤维五步骤寻找肾动脉，找到肾动脉后用威克外科结扎锁或直线切割器切断肾动脉，在其腹内下侧面稍作分离即可见肾静脉，同法处理，总结术中寻找肾血管的方法及技巧。结果：150例患者均顺利完成手术，术中按上述步骤均快速找到肾血管，缩短了手术时间，同时减少了中转开放手术及肾血管损伤的几率．手术顺利、安全。结论：按照位置、牵拉、隆起、搏动和纤维等五步骤可快速寻找到肾血管，适合在临床上推广应用。

Objective： To evaluate the method of seeking renal vessels quickly during laparoscopic nephrectomy. Methods：Retroperitoneal laparoscopic nephrectomies were performed in one hundred and fifty cases from Oct 2003 to Jun 2006. The renal arteries were seeked by five parts： position, pulling, swelling, undulating and fiber. Then the arteries were controlled by endovascular gastrointestinal stapler or Hem-o-lok clips. Then the renal veins were controlled in the same way. Results： All procedures were successfully completed. Renal vessels could be identified in short time. Operative time and risk of the vessel injury were reduced. Conclusions： Renal vessels can be seeked quickly by five parts： position, pulling,swelling,undulating and fiber.