【摘要】：近20年來,微創(chuàng)已成為胃外科的發(fā)展方向。大量臨床數(shù)據(jù)顯示,與開放手術(shù)比較,腹腔鏡胃手術(shù)不但具有美容效果,同時(shí)可減少術(shù)中失血、減輕腹腔粘連和術(shù)后疼痛、加快胃腸功能恢復(fù)以及縮短住院時(shí)間。腹腔鏡胃手術(shù)中,術(shù)中出血是最常見的并發(fā)癥,術(shù)后遲發(fā)性大出血是最危險(xiǎn)的并發(fā)癥,也是造成病人死亡的最主要原因;十二指腸殘端漏也是不可忽視的手術(shù)并發(fā)癥,應(yīng)積極應(yīng)對(duì);胰瘺發(fā)生率雖然明顯低于開放手術(shù),但同樣須認(rèn)真對(duì)待。3D腹腔鏡還原了真實(shí)的手術(shù)野且增加了放大倍數(shù),故較2D腹腔鏡具有更短的學(xué)習(xí)曲線,術(shù)中出血的發(fā)生率更低。機(jī)器人手術(shù)系統(tǒng)是外科手術(shù)的革命性成果,裸眼3D高倍圖像以及靈活防手顫的機(jī)械臂有望進(jìn)一步減少手術(shù)相關(guān)并發(fā)癥發(fā)生,從而達(dá)到微創(chuàng)、精準(zhǔn)的目的。
[Abstract]:In recent 20 years, minimally invasive surgery has become the development direction of gastric surgery. A large number of clinical data show that laparoscopic gastric surgery not only has cosmetic effect, but also can reduce intraoperative blood loss, reduce abdominal adhesion and postoperative pain, accelerate the recovery of gastrointestinal function and shorten the hospitalization time. In laparoscopic gastric surgery, intraoperative bleeding is the most common complication, postoperative delayed hemorrhage is the most dangerous complication, and it is also the main cause of death. Duodenal stump leakage is also a complication that can not be ignored, and should be dealt with actively. Although the incidence of pancreatic fistula is obviously lower than that of open surgery, it should also be taken seriously. 3D laparoscopy reduces the real surgical field and increases the magnification, so it has a shorter learning curve than 2D laparoscopy, and the incidence of intraoperative bleeding is lower. Robot surgery system is a revolutionary result of surgical surgery. 3D high power image of naked eye and flexible arm to prevent hand tremor are expected to further reduce the complications associated with surgery, so as to achieve the goal of minimally invasive and accurate.
【作者單位】： 天津醫(yī)科大學(xué)腫瘤醫(yī)院胃部腫瘤科國家腫瘤臨床醫(yī)學(xué)研究中心天津市腫瘤防治重點(diǎn)實(shí)驗(yàn)室;
【分類號(hào)】：R656.61

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