性腺血管为标记经腹腹腔镜程序化处理肾蒂的技巧

目的探讨以性腺血管为标记的经腹腹腔镜处理肾蒂的手术操作技巧。 方法2014年5月至2018年7月，中山大学第三附属医院岭南医院由同一术者进行经腹入路腹腔镜肾切除手术72例，其中单纯肾切除术42例(感染性无功能肾28例、肾结核10例、单纯无功能肾4例)，肾癌根治术22例，肾输尿管全长切除术8例。采用以性腺血管为标记的方法，解剖显露肾蒂，用Hem－o－lok处理肾蒂。 结果72例手术顺利完成，均能完好显露性腺血管并以性腺血管为标记寻找肾蒂。手术时间(148±68)min，出血量(80±57)ml，无中转开放手术，无周围脏器损伤。 结论以性腺血管为解剖标记程序化显露肾蒂血管，增加腹腔镜肾手术的手术安全性，缩短手术时间。

Technique of dissecting renal pedicle marked by gonadal vessels in transperitoneal laparoscopy

ObjectiveTo explore the technique of dissecting renal pedicle marked by gonadal vessels in transperitoneal laparoscopy. MethodsFrom May 2014 to Jul. 2018, 72 cases of laparoscopic nephrectomy were performed by the same surgeon in our department, including 42 cases of simple nephrectomy (28 cases of infectious nonfunctional kidney, including 10 cases of renal tuberculosis, 4 cases of simple nonfunctional kidney), 22 cases of radical nephrectomy and 8 cases of total nephroureterectomy. The renal pedicle was dissected by the method of gonadal vessel, and the renal pedicle was treated with Hem-o-lok. ResultsSeventy-two cases were successful. The gonadal vessels were exposed in all cases and the gonadal vessels was regarded as the marker for dissecting renal pedicle. The operation time was(148±68)min and the volume of bleeding was about (80±57)ml. There was no conversion to open surgery and no peripheral organ injury. ConclusionsThe procedure of dissecting renal pedicle vessels marked by gonadal vessels can increase the safety of laparoscopic nephrectomy and shorten the operation time.