机器人解剖性左半肝切除术

Robotic anatomic left hemihepatectomy

目前解剖性左半肝切除术正逐步成为治疗左肝内胆管结石的标准术式。患者麻醉后五孔法置入机器人机械臂及辅助Trocar。充分游离左半肝,解剖游离出左肝动脉及左侧门静脉并离断,沿左肝缺血线逐步钳夹离断肝组织,以肝中静脉左侧面为指引断肝,直达左肝静脉汇入下腔静脉处,解剖游离出左肝静脉并予离断,创面彻底止血。纵行切开胆总管前壁,胆道镜探查并取尽肝内外胆管结石,胆总管内置入T管引流,下腹正中切口取出手术标本,放置肝断面及文氏孔引流管各一根。

At present,anatomical left hemihepatectomy is gradually becoming the standard operation for the treatment of left intrahepatic bile duct calculus.the robotic arm and auxiliary Trocar were implanted by five-hole method.The left half of the liver was fully dissociated,the left hepatic artery and the left portal vein were dissected and severed,the liver tissue was gradually isolated by clamp along the left hepatic ischemia line,the liver was severed with the left side of the middle hepatic vein as the guide,and the left hepatic vein was cut directly into the inferior vena cava,the left hepatic vein was dissected and severed,and the wound was stopped completely.The anterior wall of the common bile duct was dissected longitudinally,the bile duct stones inside and outside the liver were explored and removed by choledochoscope.The T tube was inserted into the common bile duct for drainage,and the surgical specimen was removed from the median incision in the lower abdomen,and the liver section and the drainage tube of the Venn foramina were placed.