1.华中科技大学同济医学院附属协和医院,胃肠外科,湖北 武汉 430022
2.华中科技大学同济医学院附属协和医院,消化肿瘤外科,湖北 武汉 430022
曹阳,博士,主治医师,主要从事胃肠道肿瘤的微创手术治疗及研究 ,Email:michael_cy@foxmail.com
收稿:2024-01-18,
纸质出版:2024-12-22
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李源,杜周元,陶凯雄等.腹腔镜胃肠手术中发生缝针丢失的原因分析及处置[J].腹部外科,2024,37(06):448-452.
Li Yuan,Du Zhouyuan,Tao Kaixiong,et al.Causes, preventive strategies and counter-measures of needle loss during gastrointestinal laparoscopy[J].J Abdominal Surg,2024,37(06):448-452.
李源,杜周元,陶凯雄等.腹腔镜胃肠手术中发生缝针丢失的原因分析及处置[J].腹部外科,2024,37(06):448-452. DOI: 10.3969/j.issn.1003-5591.2024.06.009.
Li Yuan,Du Zhouyuan,Tao Kaixiong,et al.Causes, preventive strategies and counter-measures of needle loss during gastrointestinal laparoscopy[J].J Abdominal Surg,2024,37(06):448-452. DOI: 10.3969/j.issn.1003-5591.2024.06.009.
随着多项高级别循证临床研究结果的公布,胃肠道手术进入了微创时代,伴随着各类新术式的开展,腔镜下缝合技术在临床工作中被广泛应用。但在紧张的手术中,缝针丢失时有发生,而腔镜下视野有限,缝针尺寸更小,寻针的难度大。缝针的丢失,不仅影响手术的质量与效率,还可能导致严重的并发症。腹腔镜手术中缝针丢失重在预防,及早发现并处理尤为关键。此文通过分析2例腹腔镜胃肠手术中缝针丢失案例,总结缝针丢失的危险因素,为减少腹腔镜下缝针丢失这一不良事件的发生,针对性地提供预防措施及处理流程,有助于进一步推动腹腔镜技术在胃肠疾病中的发展。
With a publication of a growing number of high-level evidence-based clinical trial results, gastrointestinal surgery has entered a golden era of mini-invasiveness. With rapid developments of various new surgical modes, endoscopic suturing technology has also been widely applied in clinical practices. However, during stressful surgery, loss of needle occurs from time to time. Limited field of endoscopic view and smaller size of needles render it difficult to detect. Loss of needle not only affects the quality and efficiency of surgery, but also may cause severe complications. Needle loss should be prevented and early detection and timely intervention remain essential. Therefore this review described two cases of needle loss during laparoscopic gastrointestinal surgery, focused upon the risk factors of needle loss and proposed preventive measures and remedies to further promote the development of laparoscopic technology for gastrointestinal diseases.
中华医学会外科学分会 . 腹腔镜肝胆外科手术缝合技术与缝合材料选择中国专家共识(2021版) [J]. 中国实用外科杂志 , 2021 , 41 ( 5 ): 481 - 488 . DOI: 10.19538/j.cjps.issn1005-2208.2021.05.01 http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2021.05.01 .
Jayadevan R , Stensland K , Small A , et al . A protocol to recover needles lost during minimally invasive surgery [J]. JSLS , 2014 , 18 ( 4 ): e2014 .00165. DOI: 10.4293/JSLS.2014.00165 http://dx.doi.org/10.4293/JSLS.2014.00165 .
Ponrartana S , Coakley FV , Yeh BM , et al . Accuracy of plain abdominal radiographs in the detection of retained surgical needles in the peritoneal cavity [J]. Ann Surg , 2008 , 247 ( 1 ): 8 - 12 . DOI: 10.1097/SLA.0b013e31812eeca5 http://dx.doi.org/10.1097/SLA.0b013e31812eeca5 .
陈嘉瑜 . 腹腔镜手术中缝针丢失的处理建议与预防 [J]. 中国乡村医药 , 2022 , 29 ( 7 ): 19 - 20 . DOI: 10.19542/j.cnki.1006-5180.006135 http://dx.doi.org/10.19542/j.cnki.1006-5180.006135 .
汪赓 , 李钢 , 白洁 , 等 . 极度肥胖患者减重代谢手术术式选择的争议与思考 [J]. 中国普通外科杂志 , 2022 , 31 ( 10 ): 1272 - 1284 . DOI: 10.7659/j.issn.1005-6947.2022.10.002 http://dx.doi.org/10.7659/j.issn.1005-6947.2022.10.002 .
李森 , 薛勇敢 , 柯沐 , 等 . 机器人与腹腔镜手术治疗肥胖中低位直肠癌患者短期疗效比较 [J]. 解放军医学院学报 , 2023 , 44 ( 6 ): 624 - 630 . DOI: 10.3969/j.issn.2095-5227.2023.06.009 http://dx.doi.org/10.3969/j.issn.2095-5227.2023.06.009 .
张鹏 , 陶凯雄 . 肥胖病人行腹腔镜直肠癌手术的操作要点及策略 [J]. 中国实用外科杂志 , 2023 , 43 ( 10 ): 1115 - 1118 . DOI: 10.19538/j.cjps.issn1005-2208.2023.10.07 http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2023.10.07 .
中华医学会外科学分会 . 腹腔镜结直肠外科手术缝合技术与缝合材料选择中国专家共识(2021版) [J]. 中国实用外科杂志 , 2021 , 41 ( 5 ): 504 - 511 . DOI: 10.19538/j.cjps.issn1005-2208.2021.05.04 http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2021.05.04 .
胡建 , 甘军 , 薛洪源 , 等 . 熟练镜下缝合与打结争做新时代腹腔镜外科医师 [J]. 中华腔镜外科杂志 (电子版), 2019 , 12 ( 5 ): 257 - 259 . DOI: 10.3877/cma.j.issn.1674-6899.2019.05.001 http://dx.doi.org/10.3877/cma.j.issn.1674-6899.2019.05.001 .
胡建昆 , 周总光 , 杨昆 , 等 . 中国腹腔镜技术考核与评价标准体系(CLSTA) [J]. 中国实用外科杂志 , 2021 , 41 ( 9 ): 993 - 996 . DOI: 10.19538/j.cjps.issn1005-2208.2021.09.02 http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2021.09.02 .
Medina LG , Martin O , Cacciamani GE , et al . Needle lost in minimally invasive surgery:management proposal and literature review [J]. J Robot Surg , 2018 , 12 ( 3 ): 391 - 395 . DOI: 10.1007/s11701-018-0802-9 http://dx.doi.org/10.1007/s11701-018-0802-9 .
王姝 , 郎景和 , 朱兰 , 等 . 腹腔镜术中遗失缝针的寻找方法及预防策略 [J]. 协和医学杂志 , 2019 , 10 ( 4 ): 367 - 369 . DOI: 10.3969/j.issn.1674-9081.2019.04.011 http://dx.doi.org/10.3969/j.issn.1674-9081.2019.04.011 .
Feldman DL . Prevention of retained surgical items [J]. Mt Sinai J Med , 2011 , 78 ( 6 ): 865 - 871 . DOI: 10.1002/msj.20299 http://dx.doi.org/10.1002/msj.20299 .
Suh YS , Lee HJ , Yang HK . Single incision gastrectomy for gastric cancer [J]. Transl Gastroenterol Hepatol , 2016 , 1 : 41 . DOI: 10.21037/tgh.2016.05.05 http://dx.doi.org/10.21037/tgh.2016.05.05 .
陈春丽 . 腹腔镜手术中不良事件的原因分析及护理对策 [J]. 全科护理 , 2016 , 14 ( 27 ): 2881 - 2883 . DOI: 10.3969/j.issn.1674-4748.2016.27.033 http://dx.doi.org/10.3969/j.issn.1674-4748.2016.27.033 .
Barto W , Yazbek C , Bell S . Finding a lost needle in laparoscopic surgery [J]. Surg Laparosc Endosc Percutan Tech , 2011 , 21 ( 4 ): e163 - e165 . DOI: 10.1097/SLE.0b013e3182203b49 http://dx.doi.org/10.1097/SLE.0b013e3182203b49 .
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