6.4 小结
基于我们的经验,翻页式中间入路在以下几个方面存在优势:
Ⅰ.避免了传统中间入路拓展层面时可能产生的杠杆效应,避免血管损伤。
Ⅱ.使肠系膜上动静脉的各个属支更直观,更容易辨认。
Ⅲ.可以从别的途径进入并拓展横结肠后间隙及右结肠后间隙。
Ⅳ.避免为了拓展层面和解剖血管而反复翻转结肠,避免违反不触碰原则,对助手的要求相对较小。
腹腔镜右半结肠全系膜切除翻页式中间入路是安全可行的,同时也是传统中间入路的一个有效补充和优化。翻页式中间入路是一种合理的手术入路方式,适合术中发现外科解剖层面辨认不清的患者,并能降低术中血管性出血可能。
(何子锐、冯波)
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