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METHOD OF LAPAROSCOPIC SPLEEN RESECTION

机译:腹腔镜脾脏切除术

摘要

FIELD: medicine.;SUBSTANCE: method of laparoscopic spleen resection refers to medicine, namely to abdominal surgery. Patient is placed on the operating table on his/her back in the Fowler position. Under aseptic conditions under combined intubation anaesthesia in a supraumbilical region, a skin incision of 1 cm is performed, laparolifting is performed by means of clamps, and laparocentesis is performed with a Veress needle. 10 mm camera trocar is introduced with a viewing angle of 30 degrees; the instrument trocars are introduced under the control of an optics in the proposed topographic-anatomical area of the operation. Thunderbeat apparatus is used to open an omental bursa, and a gastro-splenic or colonic-splenic ligament is transected depending on the localization of the pathological focus and the required resection border. Spleen is mobilized; a splenic artery is separated at distance of 4 cm in the proximal direction from the splenic hilum to the point of branching into segmental arteries from the surrounding tissues; a soft vascular DeBakey clamp is applied on the artery with a laparoscopic clamp. Using the Thunderbeat apparatus, a pathological neoplasm is resected along the border of a healthy tissue, haemostasis of the resection line is performed by bipolar coagulation, haemostatic plates Tachocomb and haemostatic system PerClot are applied to the resection site, resected area is placed in a plastic container, removed from the abdominal cavity through a minilaparotomic incision in the left iliac region.;EFFECT: method enables performing a surgical intervention on a "dry" surgical site, which provides adequate haemostasis and visibility of clear boundaries of the resection of the organ; perform an economical resection of the organ, thereby maximally preserving the immunological and hematopoietic functions of the spleen; allows performing surgical intervention on various topographic and anatomical areas of spleen due to convenient viewing angle; also minimally invasive approach allows reducing pain syndrome and accelerating postoperative rehabilitation, which reduces time of patient’s stay in hospital.;1 cl, 1 ex
机译:领域:医学。;实质:腹腔镜脾脏切除术指的是医学,即腹部手术。患者以Fowler姿势仰卧在手术台上。在无菌条件下,在脐上区域联合插管麻醉下,进行1厘米的皮肤切口,用夹子进行腹腔镜提升,用Veress针进行腹腔镜穿刺。引入10毫米摄像头套管针,视角为30度;仪器套管针是在手术的拟议地形解剖区域的光学系统控制下引入的。Thunderbeat器械用于打开网膜囊,并根据病理病灶的位置和所需的切除边界切断胃脾韧带或结肠脾韧带。脾被激活;脾动脉从脾门到从周围组织分支成节段动脉的点在近端方向上相隔4cm;在动脉上使用软血管DeBakey夹和腹腔镜夹。使用Thunderbeat器械,沿着健康组织的边界切除病理性肿瘤,通过双极电凝对切除线进行止血,在切除部位使用止血板、速康和止血系统PerClot,将切除区域放置在塑料容器中,通过左髂区的小切口从腹腔取出。;效果:该方法能够在“干燥”的手术部位进行手术干预,提供足够的止血效果和清晰的器官切除边界;对器官进行经济的切除,从而最大限度地保留脾脏的免疫和造血功能;由于视角方便,允许对脾脏的各种地形和解剖区域进行手术干预;此外,微创方法还可以减少疼痛综合征,加快术后康复,从而缩短患者住院时间。;1个cl,1个ex

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