达芬奇系统在门静脉高压症手术中的应用及评价

贲门周围血管离断或联合脾切除术是治疗门静脉高压症最主要外科术式。近年来,随着微创理念及外科器械的进步,腹腔镜贲门周围血管离断联合脾切除术作为我国学者的一项创新并有前景的手术方式,逐渐被国内外学者接受。但受巨脾特点、手术视野、操作空间及患者凝血状态等因素的影响,腹腔镜贲门周围血管离断联合脾切除术仍然是一项高风险、高难度手术。Da Vinci手术机器人有效弥补了腹腔镜技术在视野、操作灵活性等方面的局限性,突破了腹腔镜的应用瓶颈,增加了门静脉高压症微创手术的安全性与可行性。现总结本单位实施的2例达芬奇门静脉高压症手术的过程及结果,为Da Vinci手术机器在本疾病的应用提供浅薄的经验,供外科同道参考借鉴。

The application and evaluation of robot-assisted surgery for portal hypertension

【Abstract】 Esophagogastric devascularization with or without splenectomy is the main choice of surgical treatment for portal hypertension. In recent years, as the concept of minimal invasive surgery and the surgical technology developing，laparoscopic splenectomy plus esophagogastric devascularization， an original and promising surgical procedure creating by academics of our country, is gradually accepted by academics at home and abroad. However，this procedure is limited by the situation of splenomegalia and poor coagulation status. Moreover, the visual field and operating space during laparoscopy is not satisfying. Hence splenectomy plus esophagogastric devascularization using laparoscope is still a high?risk and high?challenge procedure. Da vinci surgery system can effectively make up for the disadvantage of laparoscopy in visual field and operating space, which make minimal invasive surgery for portal hyperten?sion safer and more practicable. Here，we summarize two cases of portal hypertension treating with Da vinci surgery system，and provide our initial experiences.