腹壁提升免气腹腹腔镜手术

GASLESS LAPAROSCOPY WITH ABDOMINAL WALL LIFTING DEVICE

目的 :探索一种免除CO2 气腹的腹腔镜手术方式。方法 :设计一种器械———腹壁提升器 ,采用机械升降牵拉的方法提升腹壁形成腹腔手术空间 ,完成腹腔镜胆囊或阑尾切除。手术在连续硬膜外麻醉下进行。结果 :使用腹壁提升器免气腹的方法成功完成 2 0例胆囊切除 ,8例阑尾切除。胆囊切除平均手术时间 6 2min ,阑尾切除平均手术时间 45min。术后恢复顺利。结论 :腹壁提升器免气腹腹腔镜手术是一种全新、实用、可行、安全的微创手术方法 ,避免了气腹腹腔高压和全麻的诸多并发症 ,扩展了腹腔镜手术的应用范围 。

Objective:To study an laparoscopic surgery without carbon dioxide pneumoperitoneum.Methods:To design an instrument:Abbominal wall lifting device,using mechanical method lifted abdominal wall to offer an operating space.We have performed operations of laparoscopic choloecystectomy(LC) and laparoscopic appendectomy(LA) under epidural anesthesia by using the device to provide surgical exposure.Results:28 patients involving LC(n=20) and LA(n=8) were operated with the gasless laparascopic procedure.The average operting time was 62 minutes in LC and 45 minutes in LA.Postoperative recoveries were well in all patients.Conclusions:Gasless laparoscopy by abdominal wall lifting device is a new,practical,safe,feasible,minimal invasive surgery,avoiding many complications of pneumoperitoneum and general anesthesia. It can be used in more fields of laparoscopy.