腹腔镜解剖性肝切除手术主刀模式变迁及优化

Changes and optimization of operator model in laparoscopic anastomic hepatectomy

  • 摘要: 腹腔镜解剖性肝切除术难度大,风险高,传统的“单主刀”模式在处理术中意外情况和保障复杂手术安全性等方面略显不足。笔者团队自2014年起将“双主刀”模式应用于腹腔镜解剖性肝切除术,在施行复杂腹腔镜解剖性肝切除术时常规由2位技术熟练的外科医师同台手术,交替或同时行使传统主刀医师职责。笔者中心的经验表明:与传统的“单主刀”模式比较,“双主刀”模式能提高腹腔镜解剖性肝切除术中意外出血等紧急情况的应对能力,更好地保障手术安全性,同时能提高手术效率,增加手术流畅性,更好地保证手术的精准度和完成质量。此外,“双主刀”模式更有利于团队建设和人才培养,有助于年轻外科医师更安全、快速度过学习曲线。

     

    Abstract: Laparoscopic anatomical resection (LAR) is a highly-demanding and high risky procedure. Traditional single-surgeon technique appears to be frustrating when dealing with intro-operative emergency and ensuring the safety of complicated LAR. The authors′ department has applied two-surgeon technique when performing LAR since 2014. In complicated cases of LAR, two skillful surgeons cooperate to perform surgeries. The two surgeons stand at each side of the patient and switch their duties as the surgeon or the assistant during the operation. Experience of the authors’ department shows that compared with single-surgeon technique, two-surgeon technique can help better deal with intro-operative accidental events such as hemorrhage and guarantee the safety of LAR, as well as enhance the efficiency and quality of procedures. Two-surgeon technique benefits team building and training young laparoscopic liver surgeons, and help them pass the learning curve more safely and quickly.

     

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