非气腹腹腔镜技术的临床应用

目的研究非气腹腹腔镜手术的设计及安全性与可行性. 方法应用非气腹装置(gassless laparoscopic device,GLD)在腹腔镜下行胆总管切开取石T管引流术124例,胆总管切开取石一期缝合术56例,胆总管囊肿切除肝管空肠吻合术1例,改良非气腹腹腔镜胆总管空肠吻合术15例,手助腹腔镜脾切除联合门奇静脉断流术1例,非气腹装置辅助腹腔镜脾切除术1例. 结果手术均获成功,无严重手术并发症.129例胆道手术者随访1～9年,1例复发;2例脾脏手术者随访3～12个月,无复发. 结论所开展的非气腹腹腔镜手术达到了微创外科手术效果,安全可行.

Clinical application of gasless laparoscopy

Objective To study the operative design, safety evaluation and feasibility of gasless laparoscopic operations. Methods The gasless laparoscopic devices (GLD) were applied to 124 cases of laparoscopic choledocholithotomy with T-tube drainage, 56 cases of laparoscopic choledocholithotomy with primary bile duct suture, 1 case of laparoscopic choledochocystectomy hepaticojejunostomy, 15 cases of modified gasless laparoscopic choledochojejunostomy, 1 case of hand-assisted laparoscopic megalosplenic resection and portozygos disconnection, and 1 case of gasless device assisted laparoscopic splenectomy. Results All the operations were successfully conducted, without any severe complications. Follow-up for 1~9 years in 129 cases of biliary duct operations found 1 case of recurrence. Follow-up for 3~12 months in 2 cases of splenic operations found no recurrence. Conclusions Gasless laparoscopic operations in this study have reached minimally invasive outcomes, proven to be safe and feasible.