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Single-incision Laparoscopic Splenectomy for Massive Splenomegaly Combining gastroesophageal devascularization Using Conventional Instruments

Single-incision Laparoscopic Splenectomy for Massive Splenom...

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第十九届中国科协年会——分10微创外科高峰论坛

作者： Jun XU Lei ZHAO Zhifei WANG Bo ZHAI Chunfu LIU Department of General Surgery First Hospital of Harbin Medical University Department of General Surgery Fourth Hospital of Harbin Medical University

Background:Single-incision laparoscopic splenectomy has been reported and was proved to be feasible and *** reports on single-incision laparoscopic surgery(SILS)for massive splenomegaly is not seen,neither is SILS for gastroesophageal devascularization;another correlated procedure for patients complicated with bleeding esophageal *** February 2011 to March 2012,6 male patients with a median age of 45.1 years(range,25 to65 y) who were diagnosed of liver cirrhosis,portal hypertension,splenomegaly,and hypersplenism underwent SILS by the same surgical team in our *** them,4 patients who were indicated had combined gastroesophageal devascularization,except for 1 conversion to hand-assisted laparoscopic approach because of bleeding,the operations were performed uneventfully and the surgical outcomes were *** diagnosis was hypersplenism secondary to liver cirrhosis,the surgical outcome was *** preoperative diagnosis are,hepatitis B,the patient’s liver function is Liver Child-Pugh grade ***:The patient was placed in reverse Trendelenburg position,with the legs *** surgeon was standing on the right side of the patient and an assistant standing in between the *** 20-mm incision was made under the umbilicus,a 10-mm Trocar(Johnson & Johnson Investment ***.,NJ) was introduced in the middle of the incision,and the abdominal cavity was explored with a 10-mm,30-degree scope(Storz ***.,Germany).Then a 12-mm and a 5-mm trocar were introduced through the same incision,respectively,45 degree to the 10-mm trocar at both sides to form a "r" *** procedure started with the dissection of the splenocolic ligament at the lower pole of the spleen,followed by creating a window by dissecting the gastrocolic *** secondary branches of splenic pedicle were dissected and *** dissection of splenogastric ligament was continued along the gastric greater curvature,and short gastric vessels were encounte

关键词： single-incision laparoscopic surgery laparoscopic splenectomy massive splenomegaly gastroesophageal devascularization

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