经胃腹腔内镜手术的研究进展

自从人类首次行腹腔镜胆囊手术以来,微创手术已有了巨大发展.近2a来人们又开始了由天然管腔(natural orifice)进入腹腔进行一系列内镜下的手术操作,特别是由胃腔进入腹腔.人们已先后在动物完成了经胃内镜胃空肠吻合术和胆囊切除术;经胃腹腔内组织活检;经胃胆道系统内镜手术;经胃输卵管接扎;经胃内镜脾切除;经胃阑尾切除;经胃内镜腹膜后胰腺清创术等手术.其中一些手术已在人类完成,这为腹部手术进入真正微创提供了一个新平台.但此项技术仍处于早期发展阶段,他涉及多专科的合作,仍需要克服许多不足,不断使之完善,最终服务于临床.

Advances in experimental studies of peroral transgastric endosurgery

Since peritoneoscopic surgery was first carried out,this minimal trauma surgery has become widely applied.Recently,endoscopic surgeries from a natural orifice into the abdominal cavity have become a reality,especially for transgastric surgery of the abdomen.Various animal studies, such as those involving transgastric endoscopic gastrojejunostomy and cholecystectomy,trans- gastric abdominal tissue biopsy,transgastric cholecystic surgery,transgastric ligation of fallopian tubes,transgastric endoscopic spleen resection,endoscopic appendectomy and transgastric peripancreatic necrosis debridement, have been reported.Some of these surgical procedures have been performed in patients, indicating the emergence of this form of minimal trauma abdominal surgery.However,these surgical techniques are still at a primary stage. Further coordination between specialists should help overcome any remaining deficiencies and enable perfection of this technique,leading to its eventual clinical application.