性腺血管为标记经腹腹腔镜程序化处理肾蒂的技巧

doi:10.3877/cma.j.issn.1674-6899.2019.01.010

中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (01) : 53 -56. doi: 10.3877/cma.j.issn.1674-6899.2019.01.010

所属专题：文献；

论著

性腺血管为标记经腹腹腔镜程序化处理肾蒂的技巧

湛海伦¹^,^†(

), 杨飞¹, 李腾成¹, 李文标¹, 蔡佳荣¹, 毛云华¹, 罗云¹, 周祥福¹

^1. 510530　广州，中山大学第三附属医院岭南医院泌尿外科

收稿日期:2018-11-12 出版日期:2019-02-28
通信作者: 湛海伦
基金资助:
广东省自然科学基金项目(S2013040014333)

Technique of dissecting renal pedicle marked by gonadal vessels in transperitoneal laparoscopy

Hailun Zhan¹^,^†(), Fei Yang¹, Tengcheng Li¹, Wenbiao Li¹, Jiarong Cai¹, Yunhua Mao¹, Yun Luo¹, Xiangfu Zhou¹

^1. Department of Urology, Third Affiliated Hospital of SUN Yat-sen University, Guangzhou 510530, China

Received:2018-11-12 Published:2019-02-28
Corresponding author: Hailun Zhan
About author:
Corresponding author:Zhan Hailun, Email:hailunzhan@aliyun.com

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目的

探讨以性腺血管为标记的经腹腹腔镜处理肾蒂的手术操作技巧。

方法

2014年5月至2018年7月，中山大学第三附属医院岭南医院由同一术者进行经腹入路腹腔镜肾切除手术72例，其中单纯肾切除术42例(感染性无功能肾28例、肾结核10例、单纯无功能肾4例)，肾癌根治术22例，肾输尿管全长切除术8例。采用以性腺血管为标记的方法，解剖显露肾蒂，用Hem－o－lok处理肾蒂。

结果

72例手术顺利完成，均能完好显露性腺血管并以性腺血管为标记寻找肾蒂。手术时间(148±68)min，出血量(80±57)ml，无中转开放手术，无周围脏器损伤。

结论

以性腺血管为解剖标记程序化显露肾蒂血管，增加腹腔镜肾手术的手术安全性，缩短手术时间。

关键词: 性腺血管, 腹腔镜检查, 肾切除手术

Objective

To explore the technique of dissecting renal pedicle marked by gonadal vessels in transperitoneal laparoscopy.

Methods

From May 2014 to Jul. 2018, 72 cases of laparoscopic nephrectomy were performed by the same surgeon in our department, including 42 cases of simple nephrectomy (28 cases of infectious nonfunctional kidney, including 10 cases of renal tuberculosis, 4 cases of simple nonfunctional kidney), 22 cases of radical nephrectomy and 8 cases of total nephroureterectomy. The renal pedicle was dissected by the method of gonadal vessel, and the renal pedicle was treated with Hem-o-lok.

Results

Seventy-two cases were successful. The gonadal vessels were exposed in all cases and the gonadal vessels was regarded as the marker for dissecting renal pedicle. The operation time was(148±68)min and the volume of bleeding was about (80±57)ml. There was no conversion to open surgery and no peripheral organ injury.

Conclusions

The procedure of dissecting renal pedicle vessels marked by gonadal vessels can increase the safety of laparoscopic nephrectomy and shorten the operation time.

Key words: Gonadl vessels, Laparoscopy, Nephrectomy

图1 左侧以性腺血管为标记显露左侧肾蒂

图2 左侧以性腺血管为标记显露左侧肾蒂

图3 右侧以性腺血管为标记显露右侧肾蒂

图4 右侧以性腺血管为标记显露右侧肾蒂

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