切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 419 -424. doi: 10.3877/cma.j.issn.1674-3253.2024.05.001

专家论坛

免气腹腔镜技术在泌尿外科的应用
涂门江1, 王祥卫2,()   
  1. 1. 510630 广州,暨南大学医学院
    2. 524001 湛江,广东医科大学附属医院泌尿外科
  • 收稿日期:2024-05-23 出版日期:2024-10-01
  • 通信作者: 王祥卫
  • 基金资助:
    国家重点研发计划重点专项(2020YFA0908800); 广东省自然科学基金面上项目(2024A1515010342); 广东医科大学2024年冲补强专项资金(4SG24016G); 广东医科大学附属医院高层次人才启动基金(1035Z20230005)

Application of gasless laparoscopic technique in Urology

Menjiang Tu1, Xiangwei Wang2,()   

  1. 1. Jinan University School of Medicine, Guangzhou 510630, China
    2. Department of Urology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
  • Received:2024-05-23 Published:2024-10-01
  • Corresponding author: Xiangwei Wang
引用本文:

涂门江, 王祥卫. 免气腹腔镜技术在泌尿外科的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 419-424.

Menjiang Tu, Xiangwei Wang. Application of gasless laparoscopic technique in Urology[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(05): 419-424.

传统气腹腹腔镜是目前广泛应用在泌尿外科腹腔手术的技术。但二氧化碳(CO2)和气腹压力对机体的影响限制了其在合并心肺功能障碍、高龄、疝气、妊娠等临床特殊患者中的应用。免气腹腔镜技术通过一系列机械装置提拉或悬吊腹壁,提供足够的腹腔内手术空间,达到无需气腹而进行腔镜操作目的,同时避免了CO2气腹潜在的麻醉和手术风险,扩大了腔镜手术适应证,是腹腔镜手术的重要补充和新术式。未来,随着新器械研发和新技术融合,免气腹腔镜技术的优势将会得以更好地发挥。本文将阐述免气腹技术在泌尿外科领域的发展和应用现状。

Conventional laparoscopy has been widely utilized in Urology. However, its application in certain patient populations, such as those with cardiopulmonary compromise, the elderly, individuals with hernias, or pregnant patients, is limited due to the adverse effects of carbon dioxide (CO2) pneumoperitoneum. Gasless laparoscopic techniques, achieved by elevating or suspending the abdominal wall using mechanical devices, offer an alternative approach by creating a working space without the need to insufflate the abdomen with CO2. This technique mitigates the potential risks associated with CO2 pneumoperitoneum and expands the scope of patients suitable for endoscopic surgery, thus serving as a significant complement to traditional laparoscopic procedures. Advancements in instruments and technology integration have further enhanced the advantages of gasless laparoscopic techniques. This article provides a comprehensive review of the development and application of pneumoperitoneum-free techniques in Urology.

图1 免气腹腹腔镜前列腺癌根治术手术平台建立注:a为三孔免气腹腹腔镜前列腺癌根治术;b为单孔免气腹腹腔镜前列腺癌根治术
[1]
Nagai H, Kondo Y, Yasuda T, et al. An abdominal wall-lift method of laparoscopic cholecystectomy without peritoneal insufflation[J]. Surg Laparosc Endosc, 1993, 3(3): 175-179.
[2]
Kihara K, Kobayashi T, Kawakami S, et al. Minimum incision endoscopic surgery (MIES) in Japanese urology: results of adrenalectomy, radical nephrectomy and radical prostatectomy[J]. Aktuelle Urol, 2010, 41(Suppl 1): S15-S19.
[3]
Etwaru D, Raboy A, Ferzli G, et al. Extraperitoneal endoscopic gasless pelvic lymph node dissection[J]. J Laparoendosc Surg, 1994, 4(2): 113-116.
[4]
Hwang JH, Kim SR, Kim JH, et al. Gasless single-port access laparoscopy using a J-shaped retractor in patients undergoing adnexal surgery[J]. Surg Endosc, 2021, 35(6): 2457-2464.
[5]
肖卫星,周海军,陈炳荣,等. 悬吊免气腹腹腔镜手术治疗小儿腹股沟疝的临床研究[J]. 中华全科医学, 2022, 20(6): 970-973.
[6]
周瑶, 杨毅. 二氧化碳气腹对肝肾功能影响的研究进展[J].世界最新医学信息文摘(连续型电子期刊), 2021, 21(21): 34-36.
[7]
胡永利, 冉福林, 菅志远. 腹腔镜气腹相关并发症及原因分析[J]. 腹腔镜外科杂志, 2020, 25(6): 471-474.
[8]
Sao CH, Chan-Tiopianco M, Chung KC, et al. Pain after laparoscopic surgery: focus on shoulder-tip pain after gynecological laparoscopic surgery[J]. J Chin Med Assoc, 2019, 82(11): 819-826.
[9]
Inderbitzin DT, Mueller TU, Marti G, et al. Severe portal and systemic acidosis during CO2-laparoscopy compared to helium or gasless laparoscopy and laparotomy in a rodent model: an experimental study[J]. Surg Endosc, 2022, 36(7): 4701-4711.
[10]
Jiang M, Zhao G, Huang A, et al. Comparison of a new gasless method and the conventional CO2 pneumoperitoneum method in laparoendoscopic single-site cholecystectomy: a prospective randomized clinical trial[J]. Updates Surg, 2021, 73(6): 2231-2238.
[11]
Fukuhara H, Nishimatsu H, Suzuki M, et al. Lower incidence of inguinal hernia after radical prostatectomy using open gasless endoscopic single-site surgery[J]. Prostate Cancer Prostatic Dis, 2011, 14(2): 162-165.
[12]
Sesti F, Pietropolli A, Sesti FF, et al. Gasless laparoscopic surgery during pregnancy: evaluation of its role and usefulness[J]. Eur J Obstet Gynecol Reprod Biol, 2013, 170(1): 8-12.
[13]
Dawkins B, Aruparayil N, Ensor T, et al. Cost-effectiveness of gasless laparoscopy as a means to increase provision of minimally invasive surgery for abdominal conditions in rural North-East India[J]. PLoS One, 2022, 17(8): e0271559.
[14]
Mishra A, Bains L, Jesudin G, et al. Evaluation of gasless laparoscopy as a tool for minimal access surgery in low-to middle-income countries: a phase II noninferiority randomized controlled study[J]. J Am Coll Surg, 2020, 231(5): 511-519.
[15]
Aruparayil N, Gnanaraj J, Mishra A, et al. Gasless laparoscopy in rural India-registry outcomes and evaluation of the learning curve[J]. Surg Endosc, 2023, 37(11): 8227-8235.
[16]
Bouvy ND, Marquet RL, Jeekel H, et al. Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases[J]. Ann Surg, 1996, 224(6): 694-700;discussion 700-701.
[17]
Passot G, Dumont F, Goéré D, et al. Multicentre study of laparoscopic or open assessment of the peritoneal cancer index (BIG-RENAPE)[J]. Br J Surg, 2018, 105(6): 663-667.
[18]
王祥卫, 高新, 张炎, 等. 免气腹腹腔镜下前列腺癌根治术一例报告[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2013, 7(5): 63-64.
[19]
吴剑平, 刘春辉, 许斌, 等. 免气腹腹腔镜下前列腺癌根治性切除术[J]. 现代泌尿外科杂志, 2019, 24(3): 171-173.
[20]
Kang SC, Chen CC, Wang SY, et al. Gasless laparoscopic-assisted repair for traumatic intraperitoneal urinary bladder rupture[J]. Am Surg, 2013, 79(3): E111-E113.
[21]
孙圣坤, 寇国义, 张磊, 等. 无气腹腹腔镜膀胱根治性切除(1例报告并文献复习)[J]. 微创泌尿外科杂志, 2016, 5(1): 8-12.
[22]
Suzuki K, Masuda H, Ushiyama T, et al. Gasless laparoscopy-assisted nephrectomy without tissue morcellation for renal carcinoma[J]. J Urol, 1995, 154(5): 1685-1687.
[23]
黄君龄, 沈周俊. 免气腹腹膜后腹腔镜技术在活体供肾切取术中的应用[J]. 腹腔镜外科杂志, 2009, 14(2): 153-156.
[24]
瞿兆奎, 祁薇, 杨岗林, 等. 免气腹非全身麻醉后腹腔镜下肾囊肿去顶术[J]. 中国内镜杂志, 2011, 17(12): 1302-1304, 1307.
[25]
瞿兆奎, 祁薇, 杨岗林, 等. 硬膜外麻醉下免气腹行后腹腔镜肾盂输尿管交界处成形术27例分析[J]. 江苏医药, 2012, 38(3): 359-360.
[26]
瞿兆奎, 王权. 免气腹非全麻后腹腔镜下输尿管上段切开取石[J]. 东南大学学报(医学版), 2012, 31(3): 299-301.
[27]
王宁, 姚健, 罗黔, 等. 非气腹后腹腔镜手术在泌尿外科的应用[J]. 中国内镜杂志, 2012, 18(7): 775-777.
[28]
马楠, 杨振宇, 林旭曼, 等. 免气腹单孔后腹腔镜肾上腺肿瘤切除术初步探讨[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(1): 25-30.
[29]
杨海超, 许汉标, 石崇军, 等. 免气腹腹腔镜下隐睾下降固定术的临床应用[J]. 微创医学, 2017, 12(4): 465-467.
[30]
刘永亮, 王臣, 宋晓明, 等. 免气腹与CO2气腹腹腔镜双侧精索静脉高位结扎术的临床疗效比较[J]. 中华临床医师杂志(电子版), 2020, 14(10): 813-816.
[31]
陈金虎, 颜雷, 骆广跃, 等. 免充气腔镜下腹股沟淋巴结清扫术的临床应用[J]. 临床泌尿外科杂志, 2023, 38(7): 483-486.
[32]
Hoellen F, Rody A, Ros A, et al. Hybrid approach of retractor-based and conventional laparoscopy enabling minimally invasive hysterectomy in a morbidly obese patient: case report and review of the literature[J]. Minim Invasive Ther Allied Technol, 2014, 23(3): 184-187.
[33]
Wu DB, Yang SF, Geng KH, et al. Preliminary study on the application of an umbrella-like abdominal wall-lifting device in gasless laparoscopic surgery[J]. J Laparoendosc Adv Surg Tech A, 2013, 23(3): 246-249.
[34]
Hu H, Zhao G, Zhang K, et al. The clinical application of a self-developed gasless laparoendoscopic operation field formation device on patients undergoing cholecystectomy[J]. Surg Laparosc Endosc Percutan Tech, 2020, 30(5): 441-446.
[35]
Hwang JH, Kim BW. Gasless laparoscopic myomectomy using A J-shaped retractor and suture technique[J]. Surg Laparosc Endosc Percutan Tech, 2020, 30(4): 356-360.
[36]
王鹏, 邓高月, 吴武军, 等. 一孔双视免气腹腔镜胆囊切除术的临床研究[J/OL]. 中华腔镜外科杂志(电子版), 2012, 5(6): 504-506.
[37]
邰胜,周骏,施浩强,等. 无线智能腔镜在腹腔镜膀胱癌根治术中的运用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(1): 22-25.
[38]
Aruparayil N, Bolton W, Mishra A, et al. Clinical effectiveness of gasless laparoscopic surgery for abdominal conditions: systematic review and meta-analysis[J]. Surg Endosc, 2021, 35(12): 6427-6437.
[1] 胡森焱, 徐冬, 方健, 谢冬冬, 王财庆. ICG荧光显影Laennec膜入路腹腔镜解剖性肝切除的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 513-516.
[2] 高金红, 陈玉梅, 郭韵. 基于King互动达标理论的心理疏导在腹腔镜肝癌切除术患者的应用效果分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 517-520.
[3] 林巧, 周丽. RFA联合LAH术治疗原发性肝癌并门静脉癌栓的临床效果分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 521-524.
[4] 姜宁宁, 蔺艳丽, 陈惠明. 胆总管结石患者腹腔镜胆总管探查术中应用“三针法”缝合方案的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 531-534.
[5] 杨小栎, 李万富, 马柱, 马兰, 郑义, 付晓丽, 王晶. 钳式针一步法在小儿腹腔镜疝囊高位结扎术中的应用效果[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 535-538.
[6] 周丽, 林巧. 腹腔镜TME与开腹手术治疗原发性直肠癌对患者近远期疗效及生存率的影响比较[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 544-546.
[7] 李阳, 董峰, 曾立鹏. 局部进展期直肠癌新辅助治疗后腹腔镜TaTME与TME中的对比研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 547-550.
[8] 兰运升, 赵梓竣. 腹腔镜下高位与低位结扎肠系膜下动脉对低位直肠癌患者的影响[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 551-553.
[9] 李猛, 姜腊, 董磊, 吴情, 贾犇黎. 腹腔镜胃袖状切除术治疗肥胖合并2型糖尿病及脂肪胰的临床研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 554-557.
[10] 崔宏帅, 冯丽明, 东维玲, 韩博. 腹腔镜右半结肠癌D3根治术+IGLN清扫术治疗局部进展期结肠肝曲癌的临床效果研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 566-569.
[11] 丁志翔, 于鹏, 段绍斌. 血浆BRAF基因检测对腹腔镜右半结肠癌D3根治术中行幽门淋巴结清扫的指导价值[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 570-573.
[12] 王维花, 王楠, 乔庆, 罗红. 完全腹腔镜右半结肠癌切除术两种腔内消化道重建方案对比研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 574-577.
[13] 张金华, 赵锁. 早期ICC腹腔镜肝切除术不同淋巴结清扫范围的近远期效果对比研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 578-581.
[14] 李澄清, 郭文毅, 王磊. 腹腔镜保留脾脏胰体尾切除术:微创胰腺外科的合理决策[J]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 620-624.
[15] 陈卫波, 朱玉文, 杨豪, 陆泽坤, 邬迪, 祖广晨, 张悦, 陈学敏. 一种改良胰肠吻合方式安全性及其在腹腔镜和开腹胰十二指肠切除术中应用比较[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 498-503.
阅读次数
全文


摘要