腹腔镜手术中建立腹腔积气技术的系统性综述

Asna Zehra Naqvi, Vignesh Balasubaramaniam, Wasif Raza, Lajpat Rai, Graham S Whiteley
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摘要

近来,腹腔镜手术(LPS)越来越盛行。要将这些方法应用于临床实践,就必须深入了解微创手术特有的外科技术和多方面的器械。在这篇系统性综述中,我们关注腹腔积气形成的技术,如开放式和闭合式技术,以选择最佳的手术方法和适当的使用方法,并重点关注并发症的避免。本系统性文献综述(SLR)研究了2018年至2023年的重要发现。本SLR符合PRISMA文件建议的质量标准。资源包括 Web of Science、SCOPUS、ProQuest、ScienceDirect 和 SpringerLink。排除标准包括病例报告、摘要和信件,纳入标准包括对人类患者进行的随机、准随机、非随机和队列研究,前提是这些研究喜欢访问安全方法并提出了数值。根据研究结果,可以得出结论:必须植入插管的腹腔(AC)LP检查是安全有效的。闭合式(Veress针技术)和开放式(Hasson技术)腹腔积气诱导技术经常被使用。大多数腹腔镜手术(LP)外科医生更倾向于使用Veress针进行闭式腹腔镜手术,并在第一根套管插入时进行遮盖。然而,Veress针的批评者认为这种技术会增加血管损伤的风险。开放式哈森技术的支持者认为,血管损伤完全可以避免。利用钝头套管形成腹腔积气的开放式方法可能是 LPS 期间更安全的替代方法,这取决于安全方面的考虑。
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Systematic review on techniques for the creation of pneumoperitoneum in laparoscopic surgeries
Recently, laparoscopic surgeries (LPSs) are becoming increasingly prevalent. Incorporating these methods into clinical practice necessitates an in-depth understanding of the surgical techniques and multifaceted instrumentation that are specific to a slightly invasive operation. Within this systematic review, attention is directed to the technique for pneumoperitoneum creation, like the open and closed technique, to select optimal procedures along with appropriate utilization, with prominence on complication avoidance. This systematic literature review (SLR) examined significant findings from 2018 to 2023. This SLR complies with the quality standards suggested by the PRISMA document. Web of Science, SCOPUS, ProQuest, ScienceDirect, and SpringerLink are the resources. The exclusion criteria included case reports, abstracts, and letters, as well as inclusion criteria included randomized, quasi-randomized, non-randomized, and cohort investigations on human patients, provided that they liked access safety methods and presented values. According to the findings, it can be concluded that the LP inspection of the abdominal cavity (AC), which necessitates cannula implantation, is safe and effective. Closed (Veress needle technique) and open (Hasson technique) pneumoperitoneum induction techniques are frequently utilized. Most laparoscopy (LP) surgeons prefer closed LP utilizing a Veress needle and the first trocar’s masked insertion. Critics of the Veress needle, however, assert that this technique increases the risk of vascular injury. According to proponents of the open Hasson technique, vascular injury could be entirely avoided. The use of an open approach utilizing a blunt-tipped trocar for the formation of pneumoperitoneum may provide a potentially safer alternative during LPSs, depending on safety considerations.
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