腹腔镜肝钳在动物实验中的应用

Laparoscopic hepatic forceps for laparoscopic hepatectomy: An experimental study in pigs

目的探讨肝钳应用于家猪腹腔镜肝切除术中控制创面出血的可行性。方法用“大雄机械CAD”软件设计腹腔镜肝钳,与杭州康友医疗设备公司合作试制肝钳,观察新肝钳在腹腔镜下通过钳夹、阻断肝实质局部血流,控制肝切除创面出血的可行性。结果实验组术中出血量(47.8±6.9)m l显著少于对照组(86.3±3.9)m l(t=11.898,P=0.000),实验组切肝时间(53.2±7.4)m in显著少于对照组(97.5±5.8)m in(t=11.541,P=0.000),2组切除的肝组织重量无显著差异[实验组(34.7±4.2)g vs对照组(35.3±4.2)g(t=0.245,P=0.812)]。结论腹腔镜肝钳可阻断肝脏局部的血循环,减少腹腔镜肝切除时的出血量、缩短手术时间,有助于腹腔镜下对肝脏进行缝合等操作。

Objective To evaluate the application of a new laparoscopic hepatic forceps for laparoscopic liver resection in pigs. Methods A laparoscopic hepatic forceps was designed by using the CAD software, and was manufactured in coordination with the Hangzhou Kangyou Medical Company for pilot tests. An assessment was made on outcomes of the forceps for blocking hepatic blood flow and controlling cut surface hemorrhage in laparoscopic hepatectomy in 12 pigs. Results The experimental group had a significantly lower intraoperative blood loss than control group （47. 8 ±6.9 ml vs 86.3 ±3.9 ml;t = 11. 898,P =0.000） and a significantly shorter operation time than control （ 53.2 ± 7.4 vs 97.5 ± 5.8 rain ; t = 11. 541 , P = 0.000）. No significant difference was observed in the weight of resected liver between experimental and control groups （34. 7 ± 4. 2 g vs 35. 3 ± 4. 2 g; t = 0. 245, P =0. 812）. Conclusions This new laparoscopic hepatic forceps can be used for the occlusion of liver blood flow, offering advantages of less blood loss and shorter operation time and facilitating laparoscopic performance in liver resection.