腹腔镜下肝右后叶切除术的体位综述

Review of surgical postures for laparoscopic right posterior sectionectomy

进入微创外科时代以来,腹腔镜下肝右后叶切除术(LRPS)因为手术难度高,术中显露病灶困难,手术切除创面大,故较其它腹腔镜下肝叶切除术发展缓慢。手术体位的选择和Trocar孔的布局可以充分暴露术区,为手术成功提供保障。本综述总结了LRPS不同手术体位特点和各个体位下手术时间、术中出血、术后住院时间、术后并发症的比较以及不同体位下术区暴露技巧的运用。鉴于国内还未将LRPS的手术体位标准化,笔者希望跟各位同仁分享关于LRPS下不同手术体位的经验,为各位医师选择合适的手术体位施行LRPS提供参考。

Since entering the era of minimally invasive surgery,laparoscopic right posterior sectionectomy(LRPS)has gained slower growth compared with other laparoscopic liver resections due to high surgical difficulty,challenges in intraoperative exposure of the lesions and large wound area.The selection of surgical posture and the distribution of Trocar site can fully expose surgical area and ensure the surgical success.In this review,the characteristics of different surgical postures of LRPS,the comparison of operation time,intraoperative bleeding,length of postoperative hospital stay and postoperative complications in different postures,and the application of exposure skills in different postures were summarized.In China,surgical postures for LRPS have not been standardized.This review aims to share the experience of LRPS under different surgical postures and provide reference for selecting appropriate surgical postures for LRPS.