圆形吻合器密封置入通道装置:全腹腔镜胃癌根治术腔内吻合的一种新技术  

Laparoscopic circular stapled gastrointestinal anastomosis using novel device of sealed cap access after total laparoscopic gastrectomy

作　　者：杜建军[1] 薛洪源 赵立志[2] 张自强 许勇刚 胡建 叶琳[4] 余昌达 董元强 Du Jianjun;Xue Hongyuan;Zhao Lizhi;Zhang Ziqiang;Xu Yonggang;Hu Jian;Ye Lin;Yu Changda;Dong Yuanqiang(Department of General Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Digestive Surgery,Hanzhong Central Hospital,Hanzhong,Shanxi 723000,China;Department of Gastrointestinal Surgery,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of General Surgery,Jiujiang No.1 People's Hospital,Jiujiang,Jiangxi 332000,China;Department of General Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]复旦大学附属华山医院普通外科,上海200040 [2]陕西省汉中市中心医院消化外科,723000 [3]上海中医药大学附属曙光医院胃肠外科,201203 [4]江西省九江市第一人民医院普通外一科,332000 [5]南京医科大学第一附属医院普通外科,210029

出　　处：《中华胃肠外科杂志》2021年第4期370-371,共2页Chinese Journal of Gastrointestinal Surgery

摘　　要：圆形吻合器在全腔镜胃癌根治术中的应用存在两个难点:腔内钉砧头放置和吻合器置入腹腔的良好通道。腔内荷包缝合及钉砧头放置技术不断被优化,但目前仍缺少理想的吻合器置入通道。本文报道一种圆形吻合器置入吻合新技术,于标本取出切口放置切口保护牵开器,自其密封盖中央小孔置入钉砧头及圆形吻合器,实现了理想气腹压力维持下,简单灵巧的吻合器置入及腔内吻合。本文报道的3例在吻合过程中均无漏气,气腹维持良好,无中转开腹或使用其他吻合技术,术后恢复顺利。该圆形吻合器置入吻合新技术,可作为全腹腔镜胃癌根治腔内吻合一个新选择。Intracorporeal classic gastrointestinal anastomosis using circular stapler in totally laparoscopic gastrectomy(TLG)for gastric cancer requires intracorporeal anvil placement and suitable access for introduction of the circular stapler to the abdominal cavity without gas leak.The novel techniques for anvil placement have been updated,but there is no progress for proper access for circular stapler.In the study,intracorporeal circular-stapled gastrointestinal anastomosis were successfully accomplished using a novel device of sealed cap access with a central hole(WLB-60/70-60/100,Wuhan Widerep Medical Instrument Co.,Ltd,China)customized to the incision protection retractor for the simple and accessible introduction of the circular stapler and anvil under the optimal maintenance of pneumoperitoneum pressure in TLG.In these 3 cases,there was no gas leakage and the pneumoperitoneum was well maintained when performing the gastrointestinal anastomosis,and there was no transition to laparotomy or other anastomosis techniques.The result suggests that the sealed cap access could be a novel choice for introduction of the circular stapler to the abdominal cavity in order to obtain laparoscopic circular-stapled gastroin-testinal anastomosis in TLG.

关 键 词：胃肿瘤 完全腹腔镜手术 消化道重建 圆形吻合器 

分 类 号：R735.2[医药卫生—肿瘤]