普通微创器械下的腹腔镜脾切除术

Laparoscopic splenectomy through classic instruments

目的总结使用普通微创手术器械行腹腔镜脾切除术中的临床经验,探讨其可行性与安全性。方法对26例患者行腹腔镜脾切除术,应用一般电刀、分离钳、持针器、无损伤胃肠钳、钛夹,使用单人双手缝扎法、电凝热烫法、喷射电凝止血法等手段处理脾蒂、脾周韧带血管、脾窝创面完成脾切除术。结果 26例手术全部成功,手术时间80～420min,平均120min,术中出血量100～1000ml,平均200ml。无严重并发症发生,患者术后恢复良好。术后住院4～7d,平均5d。结论普通微创器械在腹腔镜下行脾切除术是可行的,并且成本低,副损伤小,具有一定的临床应用价值。

Objective To review the technical skills of laparoscopic splenectomy through classic instruments. Methods Twenty-six cases underwent laparoscopic splenectomy through classic instruments, including 5 cases of hypersplenism secondary to hepatic cirrhosis,21 cases of idiopathic thrombocytopenic purpura. Results Laparoscopic splenectomy though classic instruments were successfully completed in all cases,with mean operative time of 120 min,ranging from 80 to 420 rain,and mean blood loss of 200ml during operation,ranging from 100 to 1000ml.The mean postoperative hospital stays for this group of patients were 5 days （ranging from 4 to 7 days）.All patients recovered smoothly without any complication after operation. Conclusions The clinical application of laparoscopic approach to splenectomy through classic instruments is feasible and safe.