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当右截面平面并不总是平时,如何进行腹腔镜右后截切切除术?

Haowen Deng^1,2, Haoyu Hu^1,2, Dongqing Huang^1,2

¹Department of Hepatobiliary Surgery I, General Surgery Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

Annals of surgical oncology

|March 4, 2025

概括

绿色氨酸 (ICG) 光成像与增强现实导航 (ARN) 结合,为腹腔镜右后部切除术 (LRPS) 提供了一个安全和可行的解决方案,特别是在处理复杂的解剖变异时.

科学领域:

肝胆道手术肝胆道手术
手术导航技术手术导航技术
医疗成像医学成像

背景情况:

右肝静脉 (RHV) 是腹腔镜右后切除术 (LRPS) 中的一个关键里程碑.
由于解剖学变异,理论和实际手术平面之间的差异很常见,例如腹部部段VI门脉分支.
精确确定肝脏内切割平面是一个挑战.

研究的目的:

评估使用绿色氨酸 (ICG) 光成像与增强现实导航 (ARN) 用于LRPS的安全性和可行性.
在具有解剖学差异的情况下,解决确定肝脏内切割平面的挑战.

主要方法:

一名患有肝细胞癌的51岁男性接受了LRPS.
三维 (3D) 分析揭示了相对于RHV的复杂细分解剖学.
该程序涉及以RNA为指导的右后格里索纳脚 (RPGP) 的阻塞,随后进行ICG负染色以划分截面.

主要成果:

ICG光边界与手术前的3D模型完全匹配.
肝脏内切割平面通过光成像和RNA成功引导.
手术在415分钟内完成,输血量为100毫升,患者没有出现并发症.

结论:

结合RNA的ICG光成像对于LRPS是安全的和可行的.
这种综合方法有效地管理了在手术过程中遇到的不规则的右截面平面.

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