应用血管闭合系统行腹腔镜脾切除11例报告

Application of LigaSure Vessel Sealing System in Laparoscopic Splenectomy (LS):A Report of 11 Cases

目的 探讨＂结扎速＂血管闭合系统（LigaSure vessel sealing system,LVSS）在腹腔镜脾切除术（laparoscopic splenectomy, LS）中的临床应用价值. 方法 2005年8月～2006年9月,使用LVSS行LS 11例.LVSS离断脾结肠韧带及脾胃韧带,在胰尾上缘分出脾动脉,可吸收夹夹闭,在近脾门处LVSS离断脾蒂. 结果 10例LS获成功,其中9例完全应用LVSS完成手术;1例因脾蒂分离困难,应用Endo-GIA离断脾蒂.1例因脾脏与周围组织粘连紧密中转开腹.手术时间60～150 min, 平均110 min;出血量80～400 ml. 无术后大出血、胰漏、胃漏等并发症发生. 结论 LS应用LVSS有安全、止血可靠、体内无异物存留等特点.

Objective To investigate the clinical efficacy of LigaSure vessel sealing system （LVSS） in laparoscopic splenectomy （LS）. Methods From August 2005 to September 2006, 11 cases underwent LS with LVSS. LVSS was applied to cut off lienocolic ligament and gastrosplenic ligament, and separate splenic artery from the superior border of spleen tail and blocked by an absorbable clip, and then splenic stalk was separated and cut off near the hilum of spleen with LVSS. Results LS was successfully completed in 10 cases, in which 9 with LVSS entirely, and 1 case used Endo-GIA due to difficulties in splenic stalk separation. And one case was converted to laparotomy for close adhesion of spleen with the surrounding tissues. The operation time was 60 - 150 min, 110 min in average; blood loss was 80 -400 ml. No complications such as postoperative massive hemorrhage, pancreatic leakage, or gastric leakage occured. Conclusions Application of LVSS in LS is characterized by safety, reliable hemostasis, and leaving no internal foreign body.