免气腹悬吊技术在腹腔镜手术中的应用

Application of gasless lifting techniques in laparoscopic surgery

目的:探讨免气腹悬吊式腹腔镜手术的可行性及优缺点。方法:回顾分析2010年9月至2012年3月使用免气腹悬吊技术行腹腔镜手术的临床资料。其中38例行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC),6例行腹股沟疝修补术,3例行阑尾切除术,4例行精索静脉高位结扎术。结果:51例手术均获成功,其中3例在低压气腹辅助下完成手术,无一例中转开腹。手术时间14～50 min,平均25 min;术中出血量1～2 ml。术后3～5 d出院。随访1～18个月,无并发症发生。结论:免气腹悬吊式腹腔镜手术避免了CO2气腹的相关并发症,手术安全可行,更适合老年、体弱、心肺功能欠佳的患者,以及下腹部手术。

Objective：To investigate the feasibility,disadvantages and advantages of laparoscopic surgery with gasless lifting techniques.Methods：The clinical data of laparoscopic operations with gasless lifting techniques from Sep.2010 to Mar.2012 were analyzed retrospectively.51 cases were included in this study,including 38 cases of laparoscopic cholecystectomy,6 cases of inguinal hernia repair,3 cases of appendectomy and 4 cases of high ligation of spermatic vein.Results：All 51 operations were performed successfully without conversion,and 3 surgeries were assisted by low-pressure pneumoperitoneum.The operative time ranged from 14 min to 50 min（mean 25 min）.Intraoperative blood loss was 1～2 ml.The patients were discharged within 3 to 5 d.During the following-up from 1 to 18 months,no complications were recorded.Conclusions：Gasless lifting technique is safe and feasible for laparoscopic surgery,avoiding CO2 pneumoperitoneum related complications,especially for old and weak patients,patients with poor cardiopulmonary function,and operation in lower abdomen.