非气腹装置的研制及其临床应用

The development of gasless laparoscopic devices and gasless laparoscopic surgery

目的 探索自行研制的非气腹装置应用于非气腹腹腔镜手术的可行性。 方法 自1993年开始研制了五代非气腹装置 ,并逐步从动物实验应用于临床 ,实施了 12种、6 6例非气腹腹腔镜手术。 结果 6 6例非气腹腹腔镜手术中 ,5例中转开腹 (中转率 7 5 % ) ,6 1例包括胆囊切除、结直肠切除、盲肠部分切除、胃大部切除、腹股沟疝修补、腹壁紧缩成形术等获成功。 结论 非气腹腹腔镜手术不仅安全可行 ,而且充分体现了现代腹腔镜外科技术与传统外科技术的优势互补。它对因气腹禁忌而失去常规腹腔镜手术机会的患者具有重要的补充价值 ,对某些本需在腹壁造口或需扩大切口取标本的腹腔镜胃肠手术、以及手助肝、胆。

Objective To study the clinical safety and feasibility of gasless laparoscopic surgery with our homemade gasless laparoscopic devices. [WT5”HZ]Methods[WT5”BZ] Five generations of gasless laparoscopic device have been designed and manufactured independently since 1993, and 12 sorts and 66 cases of gasless laparoscopic procedure have been developed in the clinic after experimental research. [WT5”HZ]Results[WT5”BZ] Except 5 cases were converted to open surgery(conversion rate 7 5%), the other 61 cases of gasless laparoscopic cholecystectomy(41), inguinal herniorrhaphy(2), abdomino perineal resection of rectal carcinoma(9), sigmoidectomy(3), left hemi colectomy(1), hand assisted sigmoidoproctectomy(1), hand assisted right hemi colectomy(1), partial excision of cecum(1), sub total gastrectomy(1), and abdominal plasty(1) were successfully performed with no mobidity and mortality. [WT5”HZ]Conclusions[WT5”BZ] gasless laparoscopic surgery is not only safe and feasible but also reflects complementary advantages of modern laparoscopic surgery and traditional open surgery. Besides its supplementary value for the patients with cardiopulmonary diseases contraindicated to the pneumoperitoneum, it also possesses distinctive value to both gasless laparoscopic gastrointestinal surgery with an inherent incision or an incision for specimen retrieval and hand assisted gasless laparoscopic hepatobiliary and pancreatic surgery.