内窥镜镜视下切取腓肠神经的初步报告

Endoscopic harvesting of the sural nerve :a preliminary report

目的 介绍内窥镜镜视下切取腓肠神经的方法。方法 对 5例上肢神经大段缺损患者 ,沿小腿部腓肠神经行径 ,距外踝后侧 1 .5cm处作长 2cm的直切口 ,在小腿三头肌肌腹、肌腱交界处作长 2cm的直切口。利用UniversalSubcutaneousEndoscopeSystem ,在内窥镜镜视下 ,解剖分离腓肠神经后将其完整地自外踝处切口内抽出 ,并用电凝止血。将腓肠神经移植于上肢神经缺损处。结果 5例均顺利取出腓肠神经 ,在放大 1 0倍手术显微镜下观察 ,腓肠神经无明显损伤 ,患肢未发生血肿等并发症。结论 内窥镜镜视下取腓肠神经是安全的 ,并将常规手术要 35～ 40cm的大切口可缩短为长 2cm的 2～

Objective To introduce a new method of endoscopic harvesting of the sural nerve. Methods 5 cases of long nerve defect of upper extremity were involved in the study. Along the course of the sural nerve in the calf, an incision 2 cm in length was done 1.5 cm posterior to the lateral malleolus, and another incision 2 cm in length done at the junction of muscle and tendon of triceps surae. The sural nerve was pulled out of incision at the lateral malleolus under Universal Subcutaneous Endoscope System. Hemostasis was done with electric coagulation.Results There was no obvious injuries of sural nerve under the aid of magnifying loupes of 10X. No complications of hematoma occurred in all cases. Conclusions We concluded that it is safe and reliable to harvest the sural nerve using endoscope. The incision was reduced from conventional larger incision of 35 to 40 cm in length to two or three smaller incisions(2 to 3 cm).