目标:全球每年进行超过1300万例腹腔镜手术。LevaLap1.0™装置可在腹腔镜手术期间使用Verress针进行初始腹部吹气时促进安全的腹部进入。我们进行了这项研究,以检验以下假设:使用LevaLap1.0™会增加从腹壁到下层内脏和腹膜后的距离,包括主要船只。
方法:前瞻性队列研究。
方法:转诊中心。
方法:18例患者计划在全身麻醉和肌肉松弛下接受介入放射学手术。
方法:LevaLap1.0™设备在脐部和Palmer点的应用,在计算机断层扫描(CT)扫描期间。
方法:从腹壁到下面的肠的距离,在对LevaLap1.0™施加真空之前和之后,以及腹膜后血管和更远的腹内器官。
结果:该装置没有显著增加从腹壁到直接下面的肠的距离。或者,LevaLap1.0™使接入点的腹壁与脐部和Palmer点的更远处的腹内器官之间的距离显着增加(平均值±SD:3.91±2.32cm,p=0.001,+3.41±3.12厘米,分别为p=0.001)。在脐处,该装置使腹壁与腔静脉前壁之间的距离增加了5.32±1.22cm(p=0.004),或使主动脉前壁增加了5.49±1.40cm(p=0.004)。在帕尔默的位置,该装置使前腹壁与结肠和/或小肠之间的距离增加了2.13±1.81cm(p=0.023)。未报告不良事件。
结论:LevaLap1.0™使腹壁与腹膜后主要血管之间的距离增加了>5cm,在进行腹腔镜手术时,在Verress针吹气期间促进更安全的进入。
More than 13 million laparoscopic procedures are performed globally every year. The LevaLap 1.0 device may facilitate safe abdominal access when using the Veress needle for initial abdominal insufflation during laparoscopic surgery. We undertook this study to test the hypothesis that use of the LevaLap 1.0 would increase the distance from the abdominal wall to underlying viscera and the retroperitoneum, including from major vessels.
Prospective cohort study.
Referral center.
Eighteen patients scheduled to undergo an interventional radiology procedure under general anesthesia and muscle relaxation.
Application of the LevaLap 1.0 device on the umbilicus and on Palmer\'s point, during computed tomography scanning.
Distance from the abdominal wall to the underlying bowel and to retroperitoneal blood vessels and more distant intra-abdominal organs before and after vacuum was applied to the LevaLap 1.0.
The device did not significantly increase the distance from the abdominal wall to the immediate underlying bowel. Alternatively, the LevaLap 1.0 created a significant increase in the distance between the abdominal wall at the access point and more distant intra-abdominal organs at the umbilicus and at Palmer\'s point (mean ± SD: +3.91 ± 2.32 cm, p = .001, and +3.41 ± 3.12 cm, p = .001, respectively). At the umbilicus, the device increased the distance between the abdominal wall and the anterior wall of the vena cava by +5.32 ± 1.22 cm (p = .004) or the anterior wall of the aorta by 5.49 ± 1.40 cm (p = .004). At Palmer\'s point, the device increased the distance between the anterior abdominal wall and the colon and/or small bowel by 2.13 ± 1.81 cm (p = .023). No adverse events were reported.
The LevaLap 1.0 increased the distance between abdominal wall and major retroperitoneal blood vessels by >5 cm, promoting safer access during Veress needle insufflation when performing laparoscopic surgery.