Totally endoscopic surgery for thoracic esophageal cancer

胸段食管癌的全内镜手术

基本信息

批准号：
08671418
负责人：
INOUE Haruhiro
金额：
$ 1.41万
依托单位：
Tokyo Medical and Dental University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671418/
关键词：
Thoracoscopic surgery Esophageal surgery Laparoscopic surgery Total endoscopic surgery Esophageal cancer Laparoscopic reconstruction Gastric tube Advanced esophageal cancer Hand‐assided leparos copic Surpeuy 腹腔鏡下胃管作成低侵襲手術 Hand-assis

项目摘要

1) Introduction From the standpoint of minimally invasive surgery (MIS), aturhors started thoracoscopic esophagectomy in 1993. To pursue completeness of MIS,we endeavored to develop a combined procedure of thoracoscopic resection of the esophagus and laparoscopic reconstruction using gastric tube. In May 1997, the first case was successfully operated on. That procedures seems to be technically feasible and therefore we will introduce it in this video. 2) Surgical procedures and results Surgery was performed by reconstruction first, then proceeded to esophageal resection. "Laparoscopic reconstruction using gastric tube" : Lithotomy position. Five trocars were anchored under pneumoperitoneum. After dissecting esophageal hiatus, esophagus was resected at the level of abdominal esophgus using mechanical stapler. To divide short gastric vessels, hand-assisted laparoscopic surgery (HALS) was employed. Surgeon's left hand was inserted through 7-cm open laparotomy would. Preservation of right gastroepiploic artery was confidentially carried out by keeping its pulsation in surgeon's left palm. After full mobilization of the stomach, formation of the gastric tube was made under direct vision. Retrostemal reconstruction route was made through the same wound. Anastomosis between cervical esophagus and pulled-up stomach was achieved through open cervical wound. "Thoracoscopic esophagectomy" : Left lateral position and single lung ventilation. Dissection of thoracic esophagus with mediastinal lymph node dissection was carried out only by thoracoscopic forceps inserted through seven trocars on right chest wall. 3) Conclusion This MIS seems technically feasible and safe surgery for patients.

1）简介从微创外科（MIS）的角度出发，turhors于1993年开始胸腔镜食管切除术。为了追求MIS的完整性，我们致力于开发胸腔镜食管切除术和腹腔镜胃管重建的联合手术。 1997年5月，第一例手术成功。该程序在技术上似乎是可行的，因此我们将在本视频中介绍它。 2）手术过程及结果手术先行重建，然后进行食管切除。 “使用胃管的腹腔镜重建”：截石位。五个套管针固定在气腹下。解剖食管裂孔后，使用机械吻合器在腹部食管水平切除食管。为了分割短胃血管，采用了手助腹腔镜手术（HALS）。外科医生的左手穿过7厘米的剖腹手术刀插入。通过将右胃网膜动脉的搏动保持在外科医生的左手掌中，秘密地进行了保留。胃完全动员后，在直视下形成胃管。通过同一伤口进行胸骨后重建路线。通过颈部开放伤口实现颈部食管与拉起胃的吻合。 “胸腔镜食管切除术”：左侧卧位和单肺通气。仅用胸腔镜钳穿过右胸壁的七个套管针插入胸段食管并进行纵隔淋巴结清扫。 3) 结论这种 MIS 在技术上似乎是可行的，并且对患者来说是安全的手术。