There are certain hidden dangers in the past surgery to inflate the abdominal cavity
. The pneumoperitoneum retractor makes laparoscopic surgery no longer "inflated"
Compared with pneumoperitoneal laparoscopic gastric cancer surgery, pre-opening a small incision in pneumoperitoneum-free surgery can combine the advantages of open surgery and pneumoperitoneal laparoscopic minimally invasive surgery, and can easily complete difficult operations under pneumoperitoneum, which is significantly improved. The speed of the procedure, and the less invasiveness due to the reduction of the operating holes.
The reporter learned from the Cancer Hospital Affiliated to Harbin Medical University on February 14 that the pneumoperitoneum-free abdominal retractor invented by Professor Xue Yingwei, director of gastrointestinal surgery at the hospital, has been used for 30 patients since it was applied to minimally invasive surgery for early gastric cancer in April last year. A pneumoperitoneum laparoscopic radical gastrectomy for gastric cancer was successfully performed.
Practice has shown that this non-pneumoperitoneum device can facilitate the successful completion of laparoscopic exploration, dissociation, vascular occlusion and lymph node dissection, as well as tumor tissue dissection and resection.
The vast majority of patients using this device recovered well after operation, and the complications such as hypercapnia, subcutaneous emphysema, gas embolism and circulatory disturbance caused by carbon dioxide pneumoperitoneum were eliminated. The patients were discharged from hospital within 1 week on average.
Up to now, a series of researches on the pneumoperitoneum-free device have obtained 1 national invention patent and 2 utility model patents.
The effect of a pneumoperitoneum-free abdominal retractor is similar to that of a pneumoperitoneum distended state
Laparoscopic technology has been developed for more than 30 years and is now widely used in various clinical specialties.
However, there is an important link in the clinical use of laparoscopy, that is, the use of carbon dioxide to establish a pneumoperitoneum to form a surgical operation space.
After inflating the abdominal cavity, the pneumoperitoneum pressure will affect the blood flow of the lower extremities, which is unfavorable for the elderly, patients with thrombosis, and patients with cardiovascular disease, which will increase the risk of postoperative lower extremity thrombosis or pulmonary embolism, and will also cause acid-alkali in patients. Balance disorders and circulatory disorders.
These problems are uncommon, but when they occur, they can cause great harm to patients.
The series of complications caused by the use of pneumoperitoneum during the use of laparoscopy have always plagued both doctors and patients.
Since 2012, Xue Yingwei's team has started to independently develop a pneumoperitoneum abdominal retractor for use with laparoscopy, and has completed three versions of upgrades and improvements.
After 10 years of exploration and dozens of improvements and innovations, the currently developed version 4.0 pneumoperitoneum device can fully meet the clinical requirements for pneumoperitoneum laparoscopic radical gastrectomy.
This new non-pneumoperitoneum device consists of a robotic arm, a connector and three suspension hook-type abdominal wall retractors. The peripheral support frame is fixed in the slide rails between the operating beds through the slide rail joints. , the suspension arm is fixed on the support frame, and the lower end hangs the semi-circle.
The semicircular ring is connected to the abdominal wall retractor, and the abdominal wall is suspended upward, and the suspension effect is similar to the state of pneumoperitoneum distension.
No pneumoperitoneum surgery is as effective as pneumoperitoneum laparoscopic surgery
Compared with pneumoperitoneal laparoscopic gastric cancer surgery, pre-opening a small incision in pneumoperitoneum-free surgery can combine the advantages of open surgery and pneumoperitoneal laparoscopic minimally invasive surgery, and can easily complete difficult operations under pneumoperitoneum, which is significantly improved. The speed of the procedure, and the invasiveness is significantly reduced due to the reduction of the operating holes.
In addition, because there is no restriction of confined space, the suction device can perform random and continuous suction in the abdominal cavity, which is not only conducive to the treatment of intraoperative bleeding, but also can quickly absorb the smoke and water vapor generated by the use of energy equipment during the operation, so as to maintain The operative field of view is clear and clean, the contamination of the laparoscopic lens is avoided, and the quality of the operative operation is improved.
The comparison results showed that the 30 cases of laparoscopic radical gastrectomy without pneumoperitoneum were no less effective than the laparoscopic surgery in the pneumoperitoneum group.
In an interview with reporters, Xue Yingwei introduced that since the 1990s, although there have been sporadic explorations and reports on minimally invasive laparoscopic gastric cancer surgery, there has been no upsurge, especially in the laparoscopic radical gastrectomy for gastric cancer. On the other hand, there are few successful cases.
The main reason is that no medical devices have been developed. The development of pneumoperitoneum laparoscopic surgery depends on medical devices independently developed by major hospitals. Therefore, there are few clinical trials, few surgical cases, and no popularization and application. report.
Clinical practice has proved that the 4.0 version of the pneumoperitoneum device developed by Xue Yingwei's team can help laparoscopic surgery to achieve the effect of minimally invasive surgery for gastric cancer.
Pneumoperitoneum laparoscopic surgery is not only safe and feasible, but also fully reflects the complementary advantages of modern laparoscopic surgical techniques and traditional surgical techniques. Abdominal stoma or laparoscopic gastrointestinal surgery that requires an enlarged incision to take specimens also has important use value.