中国实用外科杂志 ›› 2012, Vol. 32 ›› Issue (08): 637-639.

• 专题笔谈 • 上一篇    下一篇

腹腔镜与机器人手术上消化道重建合理吻合方式

江志伟,黎介寿,李    宁   

  1. 南京军区南京总医院全军普通外科研究所,江苏南京210002
  • 出版日期:2012-08-01 发布日期:2012-07-30

  • Online:2012-08-01 Published:2012-07-30

摘要:

快速康复外科(fast track surgery)通过优化围手术期的处理加速了病人的康复速度,它是继腹腔镜外科以后的又一次外科革命。由于传统腹腔镜外科的器械及二维视野的局限,在腹腔镜下进行全胃切除后食管空肠吻合仍存在不少的困难。而机器人手术提供三维放大视野、7个自由度的器械等优势,有利于在狭小的空间内精准完成食管空肠吻合术。全机器人下吻合有利于切口的微小化以及减少术后并发症的发生,这将可能成为上消化道重建的标准手术方法之一,这也符合快速康复外科所追求的“无痛、无应激”的核心理念。

关键词: 上消化道重建, 快速康复外科, 机器人手术, 腹腔镜

Abstract:

Reasonable anastomotic mode of upper digestive tract reconstruction by laparoscopy and robotic surgery                      JIANG Zhi-wei, LI Jie-shou, LI Ning. Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China
Corresponding author: JIANG Zhi-wei, E-mail: surgery34@163.com
Abstract    Fast-track surgery optimizes the perioperative management to enhance the earlier recovery of surgical patients, and is the next revolution in surgical care following laparoscopy. Laparoscopic total gastrectomy (LTG) has not become a commonly performed procedure due to the difficulties associated with using long rigid instruments to perform esophagojejunostomy, which are further constrained by the two-dimensional laparoscopic view. The da Vinci robot surgical system provides 3D visualization, enhanced magnification, and seven degrees of freedom of the instruments to suture and knot in the narrow surgical space. So a robot-sewing anastomosis for esophagojejunostomy reconstruction in robotic total gastrectomy for gastric cancer is feasible with painless and stressless and may be a standard surgical technique.

Key words: upper digestive tract reconstruction, fast track surgery, robotic surgery, laparoscope