Abstract:
An omentectomy is a standard component care of gynecological cancers, particularly for surgical staging and treatment for malignant ovarian neoplasms, borderline tumors, fallopian tube cancers, primary peritoneal cancers as well as certain histological subtypes of endometrial cancer. Traditionally, an omentectomy is performed by an open laparotomy approach, however, use of a robotic approach has gained popularity and has been proven to be both safe and effective. In spite of the advantages of robotic surgery compared to laparotomy, the inherent technical challenges of a robotic omentectomy may limit its uptake. In this article, we review (1) the physiology and surgical anatomy of the omentum, (2) the role of the omentum in immune regulation and oncogenesis, (3) indications for an omentectomy in the setting of gynecological malignancy, and (4) describe a step-by-step 3-arm technique for performing both a infracolic and gastrocolic omentectomy procedure using a robotic approach.
摘要:
网膜切除术是妇科癌症的标准组成部分,特别是对于恶性卵巢肿瘤的手术分期和治疗,交界性肿瘤,输卵管癌,原发性腹膜癌以及子宫内膜癌的某些组织学亚型。传统上,通过开腹手术进行网膜切除术,然而,使用机器人的方法已经得到普及,并已被证明是安全和有效的。尽管与剖腹手术相比,机器人手术具有优势,机器人网膜切除术的固有技术挑战可能会限制其吸收。在这篇文章中,我们回顾了(1)网膜的生理和外科解剖学,(2)网膜在免疫调节和肿瘤发生中的作用,(3)在妇科恶性肿瘤中进行网膜切除术的适应症,和(4)描述了一种逐步的3臂技术,用于使用机器人方法进行结肠内和胃结肠网膜切除术。