3D高清腹腔镜在小儿外科的临床应用初探  

Preliminary application of robotic-assisted 3-dimentional high-definition laparoscopy in children

作　　者：刘江斌[1] 李会[1] 吴一波[1] 徐伟珏[1] 吕志宝[1] 

机构地区：[1]上海交通大学附属儿童医院外科,200062

出　　处：《中华小儿外科杂志》2015年第7期532-535,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的总结3D高清腹腔镜在治疗小儿外科常见疾病的初步经验，评估其安全性和有效性。方法回顾性分析2014年2月至2014年4月，上海市儿童医院／上海交通大学附属儿童医院外科采用德国产蛇牌“爱因斯坦”智能机器人臂辅助3D高清腹腔镜系统手术治疗胆总管囊肿、地中海贫血所致脾功能亢进／巨脾、卵巢浆液性囊腺瘤和急性阑尾炎等各1例的临床资料。其中，胆总管囊肿采用腹腔镜下将扩张的胆总管囊肿切除后、于腹腔外行空肠-空肠端侧吻合，最后行肝总管空肠吻合；地中海贫血所致脾功能亢进／巨脾在全腹腔镜下切除脾脏，将整个脾脏套入标本袋，经脐部切口直视下将脾脏剪成小块后取出；急性阑尾炎采用3孔法腹腔镜阑尾切除术；卵巢肿瘤采用腹腔镜卵巢囊肿剥除，将整个囊肿置入标本袋后经脐部切口取出，并保留部分正常卵巢组织，手术后病理为卵巢浆液性囊腺瘤。结果3例均在3D高清腹腔镜下完成手术，无中转开腹者；与2D相比，3D高清腹腔镜提供的图像画面立体感强，视野清晰；智能机器人臂辅助明显减少了手术助手的疲劳。所有手术均由1位医生主刀完成，手术时间与手术出血量等与2D腹腔镜完成类似手术基本相同。术中及术后随访至今未见手术并发症。结论应用3D高清腹腔镜治疗小儿外科常见疾病是可行的；该系统可为术者提供精确的立体空间图像，有利于医生进行精准的外科操作。Objective To review the experiences of clinical application of 3-dimentional high- definition （3D-HD） laparoscopy in children. Methods The clinical data of 4 cases operated by 3D-HD laparoscopy were analyzed including choledoehoeyst, ovary cyst, thalassemia with splenomegaly and acute appendicitis at Children＇s Hospital of Shanghai or Shanghai Jiao Tong University from February to April 2014. Laparoscopic choledochal cyst excision with Roux-Y hepaticojejunostomy was performed successfully. Ovary cyst and splenomegaly caused by thalassemia were resected by laparoscopy and the pathological diagnosis was serous eystadenoma. Laparoscopic appendectomy was completed by 3-site procedure. Results All laparoseopie procedure were completed successfully without conversion into open surgery. The operative duration and intra-operative bleeding volume were similar to those of conventional 2D laparoseopy. And all patients were followed up till now and there was no surgical complication. The 3D-HD system could provide more precise depth perception, spatial location, movement velocity and improved surgical performance. Conclusions 3D-HD laparoscopic system provides three-dimensional perception, especially on instrument path length, usability, visual comfort and quality of image transmission. With improved quality of vision, laparoscopic surgeons may benefit from 3D imaging and perform precise operations.

关 键 词：腹腔镜检查 成像 三维 治疗结果 

分 类 号：R726[医药卫生—儿科]