在常规制备后腹腔空间后，往往需要清除腹膜外脂肪，这些脂肪采取何种方式取出体外，鲜有文献描述。本文将介绍南方医科大学珠江医院泌尿外科设计的一种使用吸引管快速清除腹膜外脂肪的技术，并评价其安全性及有效性。

自2016年1月至2023年3月，在后腹腔镜手术中，患者取健侧卧位，腰部垫高，升高腰桥，按常规制备操作空间和三孔法放置套管，进后腹腔空间后，使用超声刀和抓钳，整块清理腹膜外脂肪，脂肪的滋养血管使用超声刀封闭。腹膜外脂肪剥离完毕后，将剪除头端的吸引管置入10 mm套管，进入套管前，在外侧先将吸引管弯折，避免进入后腹腔后导致压力骤降。将管口抵住腹膜外脂肪表面，松开戳卡外的弯折，部分脂肪组织吸入吸引管。边吸住腹膜外脂肪边快速将脂肪剪碎。借助负压，剪碎的脂肪组织先后进入吸引管。遇到较硬、较大的脂肪组织堵塞吸引管时，可将吸引管自套拔出，以50 ml注射器向管内推注空气，持续加压，推动脂肪组织移动，直至腹膜外脂肪清理完成，弯折吸引管再将其拔出。使用纱条擦拭操作平面，再根据疾病种类进行下一步手术操作。

共完成泌尿外科各类后腹腔镜手术的简化吸脂操作762例，所有后腹腔镜手术均获得成功，吸引管简化吸脂肪清除腹膜外脂肪成功率100%。吸脂时间10 sec至5 min，其中无换用其他清脂法。未发生与吸除腹膜外脂肪相关的操作并发症。762例患者手术病种涵盖泌尿系统上尿路畸形、损伤、感染与炎症、结石、肿瘤等几乎所有疾病。

简化吸脂法清除腹膜外脂肪具有操作简单、节约手术时间、去除脂肪彻底等优点。

Preparation of the retroperitoneal space, removal of extraperitoneal adipose tissue is often required, and in order to find how to remove these adipose tissue from the body, this article will introduce a technique designed by the Department of Urology, Zhujiang Hospital of Southern Medical University to rapidly remove extraperitoneal adipose tissue using a suction tube, and the safety and efficacy will be evaluated.

From January 2016 to March 2023, in retroperitoneoscopic surgery, the patients were placed in healthy lateral position, with high lumbar pad. The trocar was placed according to the conventional preparation operating space and three holes. After entering the retroperitoneal space, the extraperitoneal adipose tissue was removed using harmonic scalpel and grasping forceps, and the nutrient vessels of adipose tissue were cleared.After the completion of extraperitoneal adipose tissue dissection, the suction tube was placed into a 10 mm trocar. Before entering the trocar, bend the suction tube on the lateral side to avoid sudden pressure drop after entering.Place the tube against the extraperitoneal adipose tissue, release the bend, and suck part of adipose tissue into the suction tube.Quickly mincing adipose tissue while sucking .With the aid of negative pressure, the minced adipose tissue successively entered the suction tube.When the suction tube was blocked by hard and large adipose tissue, the suction tube can be pulled out from the trocar, air can be injected into the tube with a 50 ml syringe, push the adipose tissue to move until the extraperitoneal adipose tissue was cleaned, and the suction tube can be bent and then pulled out.Use gauze to wipe the operating plane, and then perform the next surgical operation according to the type of disease.

A total of 762 cases of simplified liposuction were completed in various types of retroperitoneoscopic surgery in urology. All retroperitoneoscopic surgeries were successful. The success rate of simplified liposuction with suction tube in removing extraperitoneal adipose tissue was 100%.Liposuction time ranged from 10 sec to 5 min, with no switch to other lipid-clearing methods.There were no procedural complications associated with suction of extraperitoneal adipose tissue.The surgical diseases of 762 patients covered almost all diseases such as upper urinary tract malformations, injuries, infections and inflammation, stones, and tumors of the urinary system.

The simplified liposuction method to remove extraperitoneal adipose tissue has the advantages of simple operation, saving operation time and removing adipose tissue thoroughly.