1.3 小结
3D 腹腔镜在右半结肠癌CME 手术中，尽显其优点：手术野清晰、三维空间感尤其是纵深感极强，尤其进入到较深在的部位如右侧Toldt’s 融合筋膜间隙内，如若身临其境，将右结肠及其系膜相关的膜解剖关系展示得淋漓尽致。在胰头部显露胰十二指肠前筋膜下方的GTH 的各分支时，可以很好地辨识各分支汇入GTH 的毗邻关系，可以减少医源性损伤。而当完成CME+D3 根治术行消化道重建时，尤其在关闭共同开口时，镜下采用Gambee 缝合技术更加便捷，夹持针及肠管各层间的对合更加安全可靠。
此外，3D 腹腔镜导光束和镜头光纤在镜子尾部避免了对主刀器械的干扰。简言之，清晰、精准、安全，是3D 腹腔镜在右半结肠癌CME 手术中带给外科医生的感受，而笔者通过大量临床实践得出单孔3D 腹腔镜在加速康复及美容效果方面要明显优于传统多孔腹腔镜手术。当然，随着单孔手术器械、腹腔镜硬件设备的推陈出新，应用软件的研发，实时导航及更加智能化的操作，将改变外科医生对疾病的认识并带动单孔腹腔镜外科技术继续提高。3D+4K+荧光已成为现实，而光学腹腔镜向功能腹腔镜的发展指日可待，多孔腹腔镜手术向单孔、自然孔道（NOTES）手术发展成为可能。
（燕速）
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