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腹腔镜手术中应用的进腹技术

Authors
Aurora Pryor, MD
Gerald Gracia, MD
Section Editor
Jeffrey Marks, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS
Translators
臧潞, 副主任医师，副教授

引言

腹腔镜技术在外科领域引起了革新；与传统的开腹手术相比，腹腔镜技术带来的获益包括：降低术后疼痛；术后更早恢复正常活动；术后并发症(如，伤口感染、疝)更少[1]。然而，为了进行腹腔镜手术而施行的进腹操作具有独特的并发症。意外所致的肠损伤或大血管损伤不常见，但都是可能威胁生命的并发症，最可能发生于初次进腹时[2-6]。

进入腹膜腔的技术、进入技术的选择、安置位置和单切口术的入路安置将总结在此。而腹腔镜术进腹的并发症将在另外的专题中讨论。 (参见“腹腔镜手术的并发症”)

腹壁解剖学

腹壁的解剖学知识对于安全置入腹腔镜进腹设备是必需的。这些装置依次穿过皮肤、皮下脂肪、多种肌筋膜层、腹膜前脂肪和壁腹膜。

进腹位置 — 腹壁的筋膜层和肌层根据具体的位置也是多变的。典型的腹腔镜进腹位置的解剖学及相关的腹内解剖学将在下文讨论。详细的腹壁解剖学将在别处讨论。 (参见“腹壁解剖学”)

腹中线 — 腹壁中线没有重要的血管和神经分布，因此是许多腹腔镜操作首选的初始进腹位置。 (参见下文‘先进的进腹技术’)

                                                  

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Literature review current through: 2017-06 . | This topic last updated: 2016-11-08.
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