Name: application of end-to-end anastomosis in robotic central pancreatectomy
Uploaded: 2018-06-02T13:30:00
Description: Watch this Scientific Journal Video about Application of End-to-end Anastomosis in Robotic Central Pancreatectomy at JoVE.com

Forfatterne har ingen takk.

Skriftlig samtykke ble innhentet fra pasienten for utgivelsen av denne rapporten og alle tilhørende videoer og bilder.
1. preoperativ forberedelse
<ol><li>Nøye vurdere preoperativ bilder av CT eller Mr for den nøyaktige plasseringen av svulsten og dens forhold til omkringliggende vev.</li>
	<li>Gi pasienten en bløt kosten dagen før operasjonen og begynne faste ved midnatt før operasjonen.</li>
	<li>Plass pasienten i drifts tabellen. Deretter plasserer en perifert venekateter og induser...

<ol>
	<li>Goudard, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reappraisal+of+central+pancreatectomy+a+12-year+single-center+experience.">Reappraisal of central pancreatectomy a 12-year single-center experience.</a> JAMA Surg. 149 (4), 356-363 (2014).</li><li>Iacono, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Systematic+review+of+central+pancreatectomy+and+meta-analysis+of+central+versus+distal+pancreatectomy.">Systematic review of central pancreatectomy and meta-analysis of central versus distal pancreatectomy.</a> Br J Surg. 100 (7), 873-885 (2013).</li><li>Sperti, C., Beltrame, V., Milanetto, A. C., Moro, M., Pedrazzoli, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Parenchyma-sparing+pancreatectomies+for+benign+or+border-line+tumors+of+the+pancreas.">Parenchyma-sparing pancreatectomies for benign or border-line tumors of the pancreas.</a> World Journal of Gastrointestinal Oncology. 2 (6), 272-281 (2010).</li><li>Kim, D. H., Kang, C. M., Lee, W. J., Chi, H. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+central+pancreatectomy+with+pancreaticogastrostomy+(transgastric+approach)+in+a+solid+pseudopapillary+tumor+of+the+pancreas.">Robotic central pancreatectomy with pancreaticogastrostomy (transgastric approach) in a solid pseudopapillary tumor of the pancreas.</a> Hepato-gastroenterology. 58 (110-111), 1805-1808 (2011).</li><li>Addeo, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+central+pancreatectomy+with+stented+pancreaticogastrostomy:+operative+details.">Robotic central pancreatectomy with stented pancreaticogastrostomy: operative details.</a> The international journal of medical robotics + computer assisted surgery: MRCAS. 7 (3), 293-297 (2011).</li><li>Abood, G. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic-assisted+minimally+invasive+central+pancreatectomy:+technique+and+outcomes.">Robotic-assisted minimally invasive central pancreatectomy: technique and outcomes.</a> J Gastrointest Surg. 17 (5), 1002-1008 (2013).</li><li>Schwarz, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Total+Laparoscopic+Central+Pancreatectomy+with+Pancreaticogastrostomy+for+High-Risk+Cystic+Neoplasm.">Total Laparoscopic Central Pancreatectomy with Pancreaticogastrostomy for High-Risk Cystic Neoplasm.</a> Annals of surgical oncology. 23 (3), 1035 (2016).</li><li>Topal, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pancreaticojejunostomy+versus+pancreaticogastrostomy+reconstruction+after+pancreaticoduodenectomy+for+pancreatic+or+periampullary+tumours:+a+multicentre+randomised+trial.">Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial.</a> The Lancet Oncology. 14 (7), 655-662 (2013).</li><li>Lemaire, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+and+morphological+changes+in+the+pancreatic+remnant+following+pancreaticoduodenectomy+with+pancreaticogastric+anastomosis.">Functional and morphological changes in the pancreatic remnant following pancreaticoduodenectomy with pancreaticogastric anastomosis.</a> Br J Surg. 87 (4), 434-438 (2000).</li><li>Rault, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pancreaticojejunal+Anastomosis+Is+Preferable+to+Pancreaticogastrostomy+after+Pancreaticoduodenectomy+for+Longterm+Outcomes+of+Pancreatic+Exocrine+Function.">Pancreaticojejunal Anastomosis Is Preferable to Pancreaticogastrostomy after Pancreaticoduodenectomy for Longterm Outcomes of Pancreatic Exocrine Function.</a> Journal of the American College of Surgeons. 201 (2), 239-244 (2005).</li><li>Lai, E. C., Tang, C. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+distal+pancreatectomy+versus+conventional+laparoscopic+distal+pancreatectomy:+a+comparative+study+for+short-term+outcomes.">Robotic distal pancreatectomy versus conventional laparoscopic distal pancreatectomy: a comparative study for short-term outcomes.</a> Frontiers of medicine. 9 (3), 356-360 (2015).</li><li>Konstantinidis, I. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+total+pancreatectomy+with+splenectomy:+technique+and+outcomes.">Robotic total pancreatectomy with splenectomy: technique and outcomes.</a> Surg Endosc. , (2017).</li><li>Liu, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+surgical+outcomes+of+robot-assisted+laparoscopic+pancreaticoduodenectomy+versus+laparoscopic+pancreaticoduodenectomy+for+periampullary+neoplasms:+a+comparative+study+of+a+single+center.">The surgical outcomes of robot-assisted laparoscopic pancreaticoduodenectomy versus laparoscopic pancreaticoduodenectomy for periampullary neoplasms: a comparative study of a single center.</a> Surg Endosc. 31 (6), 2380-2386 (2017).</li><li>Lui, R., Zhao, G., Yin, Z., Zhao, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+enucleation+for+pancreatic+neoplasm+with+interposition+repair+of+the+main+pancreatic+duct:+a+case+report.">Robotic enucleation for pancreatic neoplasm with interposition repair of the main pancreatic duct: a case report.</a> Chinese Journal of Laparoscopic Surgery. 9 (6), 373-374 (2016).</li><li>Ehrhardt, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ueber+Resektionen+am+Pankreas1.">Ueber Resektionen am Pankreas1.</a> DMW-Deutsche Medizinische Wochenschrift. 34, 595-597 (1908).</li><li>Wolk, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+central+pancreatectomy+and+pancreatic+enucleation+as+pancreatic+resections--A+comparison.">Evaluation of central pancreatectomy and pancreatic enucleation as pancreatic resections--A comparison.</a> Int J Surg. 22, 118-124 (2015).</li><li>Ishii, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Remnant+pancreas+reconstruction+with+duct-to-duct+anastomosis+after+middle+pancreatectomy:+a+report+of+two+cases.">Remnant pancreas reconstruction with duct-to-duct anastomosis after middle pancreatectomy: a report of two cases.</a> Hepato-gastroenterology. 62 (137), 190-194 (2015).</li><li>Di Benedetto, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Meso-pancreatectomy:+new+surgical+technique+for+Wirsung+reconstruction.">Meso-pancreatectomy: new surgical technique for Wirsung reconstruction.</a> J Am Coll Surg. 214 (2), 1-4 (2012).</li><li>Oida, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=End-to-end+anastomosis+after+medial+pancreatectomy+for+tumor.">End-to-end anastomosis after medial pancreatectomy for tumor.</a> Hepato-gastroenterology. 54 (76), 1266-1268 (2007).</li><li>Ramesh, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=End-to-end+anastomosis+of+pancreas.">End-to-end anastomosis of pancreas.</a> Surgery. 131 (6), 691-693 (2002).</li><li>Kang, C. M., Kim, D. H., Lee, W. J., Chi, H. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Initial+experiences+using+robot-assisted+central+pancreatectomy+with+pancreaticogastrostomy:+a+potential+way+to+advanced+laparoscopic+pancreatectomy.">Initial experiences using robot-assisted central pancreatectomy with pancreaticogastrostomy: a potential way to advanced laparoscopic pancreatectomy.</a> Surgical endoscopy. 25 (4), 1101-1106 (2011).</li><li>Lee, J. W., Yoo, J., Ko, J. W., Choi, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+Central+Pancreatectomy+with+Pancreaticojejunostomy+for+Solid+Pseudopapillary+Neoplasm.">Robotic Central Pancreatectomy with Pancreaticojejunostomy for Solid Pseudopapillary Neoplasm.</a> Journal of Minimally Invasive Surgery. 20 (2), 74-76 (2017).</li><li>Ronnekleiv-Kelly, S. M., Javed, A. A., Weiss, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Minimally+invasive+central+pancreatectomy+and+pancreatogastrostomy+current+surgical+technique+and+outcomes.">Minimally invasive central pancreatectomy and pancreatogastrostomy current surgical technique and outcomes.</a> The Journal of Visualized Surgery. 2 (8), (2016).</li><li>Liu, R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotic+versus+laparoscopic+distal+pancreatectomy:+A+propensity+score-matched+study.">Robotic versus laparoscopic distal pancreatectomy: A propensity score-matched study.</a> Journal of surgical oncology. 116 (4), 461-469 (2017).</li></ol>

Ondsinnethet svulst i bukspyttkjertelen halsen og den proksimale delen av bukspyttkjertelen kroppen er ofte behandlet med pancreaticoduodenectomy eller distale pancreatectomy. Men for godartet eller lav ondartet potensielle svulster i disse områdene, den standard pancreaticoduodenectomy eller distale pancreatectomy fjerner overdreven normalt vev og føre til overdreven skade. Derfor blir den sentrale pancreatectomy eller bukspyttkjertelen enucleation, kjent som «parenchyma-sparing pancreatectomy», en foretrekke valg f...

Sentrale pancreatectomy utføres stadig for behandling av godartet eller lav-ondartet potensielle svulst i bukspyttkjertelen halsen eller proksimale del av bukspyttkjertelen kroppen1. Sammenlignet med pancreaticoduodenectomy eller distale pancreatectomy, sentrale pancreatectomy resects mindre vev og sparer mer bukspyttkjertelen parenchyma og funksjon. Foreløpig er de store tilnærmingene for bukspyttkjertelen gjenoppbyggingen over sy cephalic bukspyttkjertelen stump og utfører en pancreaticojejunostomy eller pancreaticogastrostomy til den distale stubbe2,3. Disse to tilnærmingene er mye brukt i åpen, laparoskopisk og robotic sentrale pancreatectomies4,5,6,7. Men bryte de nevnte to rekonstruksjon tilnærmingene anatomiske kontinuiteten i fordøyelseskanalen og veien for utskillelse av bukspyttkjertelen væske. I direkte kontakt med bukspyttkjertelen stubbe med intestinal juice kan øke muligheten for blødning og fistel8. Selv om magesyre kan inaktiv bukspyttkjertelen enzymer for å unngå erosjon av anastomose, det kan føre til exocrine pancreatic mangelfull, og på lang sikt svekker pasientens ernæringsmessig status9,10.
Med utviklingen av minimal invasiv kirurgi, robot kirurgi har vist store fordeler i sin 3D forstørrende vise, stabilitet, og fleksibiliteten av bevegelser, etc., som gir forbedret dissekere og suturing kapasitet for anastomose og hemostasen11,12. Basert på vår erfaring i robot pancreatectomy og reparer for skadde bukspyttkjertelen duct13,14, har vi utført en rekke robot sentrale pancreatectomy med ende-til-ende anastomose og sett gunstig utfall. Sammenlignet med pancreaticojejunostomy eller pancreaticogastrostomy, unngår ende-til-ende bukspyttkjertelen anastomose skader fordøyelseskanalen; dermed teoretisk reduserer muligheten for pancreaticoenteric fistel. Men på den annen side, ende-til-ende bukspyttkjertelen anastomose utgjør større tekniske problemer. Som en oppdatering av konvensjonelle sentrale pancreatectomy er kandidater for konvensjonelle sentrale pancreatectomy også kvalifisert for denne operasjonen. Her presenterer vi operative teknikker for robotic sentrale pancreatectomy ende-til-ende anastomose i en høyere hepatopancreatobiliary i dette tilfellet videopresentasjon.
Indikasjoner:
(1) Benign og lav-ondartet potensielle svulst i bukspyttkjertelen halsen og proksimale kroppen er egnet for denne operasjonen. (2) feil viktigste bukspyttkjertelen rørdybden må være mindre enn 5 cm etter det sentrale pancreatectomy, og størrelsen på tumor ikke er den største bekymringen for gjenoppbygging.
Case-presentasjon:
Pasienten er en 31 år gammel mann. En leksjonen i bukspyttkjertelen nakken ble funnet ved et uhell i en legeundersøkelse 2 år siden. Han gjennomgikk vanlige revurdering og lesjonen ble funnet forstørres asymptomatically nylig. Han hadde ingen historie forrige abdominal kirurgi. På fysisk undersøkelse eksisterte ingen positive tegn. Bukspyttkjertelen Mr viste en kvasi sirkulær leksjonen ca 14mm i bukspyttkjertelen nakken; Dette ble antatt som en Nevroendokrine. På T1 og T2-avveid imaging, den leksjonen viste hypointense og hyperintense signal, henholdsvis. På diffusjon-vektet bildebehandling, lesjonen viste hyperintense signal. Lesjonen var litt forbedret i arterial fase og viste en progressiv ekstrautstyr mønster i parenchyma fase og forsinkelse fase (figur 1). Alvorlig fettlever var også diagnostisert av Mr. Ingen dilation eller striktur ble oppdaget i bukspyttkjertelen røret. Rutinemessig blodet eksamen, IgG isoformen test, svulst biomarkers, elektrokardiogram og brystet X-ray var vanlig. Biokjemiske testen viste litt forhøyet ALT (alanin aminotransferase) på 147.3 U/L og AST (Aspartate aminotransferase) på 53.9U / L, som skyldes fettlever.

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			<td height="42" style="height:42px;width:205px;">da Vinci Robotic Surgical System</td>
			<td style="width:296px;">Intuitive&#160;Surgical, USA</td>
			<td style="width:113px;">Si</td>
			<td style="width:159px;"></td>
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			<td height="42" style="height:42px;width:205px;">EndoWrist Permanent Cautery Hook</td>
			<td>Intuitive&#160;Surgical, USA</td>
			<td style="width:113px;">420183</td>
			<td></td>
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			<td height="21" style="height:21px;width:205px;">Harmonic Ace Curved Shears</td>
			<td>Ethicon, USA</td>
			<td style="width:113px;">420275</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">EndoWrist Large needle Driver</td>
			<td>Intuitive&#160;Surgical, USA</td>
			<td style="width:113px;">420006</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">EndoWrist Cadiere Forceps</td>
			<td>Intuitive&#160;Surgical, USA</td>
			<td style="width:113px;">420049</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">EndoWrist Black Diamond Micro Forceps</td>
			<td>Intuitive&#160;Surgical, USA</td>
			<td style="width:113px;">420033</td>
			<td></td>
		</tr>
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			<td height="42" style="height:42px;width:205px;">Lapro-Clip 8 mm Absorbable Clips</td>
			<td>Covidien&#160; , USA</td>
			<td style="width:113px;">8886848882</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">5-0 non-absorbable suture</td>
			<td>Ethicon, USA</td>
			<td style="width:113px;">M8717</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">4-0 non-absorbable suture</td>
			<td>Ethicon, USA</td>
			<td style="width:113px;">D9775</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">5-0 absorbable suture</td>
			<td>Ethicon, USA</td>
			<td style="width:113px;">D9943</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">Absorbable hemostas</td>
			<td>Ethicon, USA</td>
			<td style="width:113px;">W1912</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Laparoscopic Ultrasound Probe</td>
			<td>BK Ultrasound, Denmark</td>
			<td style="width:113px;">8666-RF</td>
			<td>transducer contact surface: 30*5mm; Frequence: 4.3-10 MHz</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">Pancreatic stent</td>
			<td>Yaxin Medical, Suzhou, China</td>
			<td style="width:113px;">1.2 mm&#160;</td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Antibiotics&#160;(ceftriaxone sodium for injection)</td>
			<td style="width:296px;">Roche, Shanghai, China</td>
			<td style="width:113px;">H10983036</td>
			<td>ceftriaxone sodium (2g) adding to normal saline (100ml), once per day.</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Proton pump inhibitors (lansoprazole injection)&#160;</td>
			<td style="width:296px;">Luoxin Pharmaceutical, Linyi, China</td>
			<td style="width:113px;">H20055118</td>
			<td>lansoprazole injection (30 mg) adding to normal saline (100ml), twice per day.</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Somatostatin (Somatostatin for injection)</td>
			<td style="width:296px;">Merck Serono, Germany</td>
			<td style="width:113px;">H20090929</td>
			<td>Somatostatin for injection (6000ug) adding to nornal saline to a total of 48ml, 2 ml/h</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">Analgesic</td>
			<td style="width:296px;"></td>
			<td style="width:113px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Analgesic (sufentanil Citrate injection)</td>
			<td style="width:296px;">Humanwell Healthcare, Fuzhou, China</td>
			<td style="width:113px;">H20054171</td>
			<td>sufentanil Citrate (200ug),&#160; Ondansetron hyrochloride (20mg), adding to normal saline to a total of 80 ml, 1 ml/h</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Analgesic (Ondansetron hyrochloride injection)</td>
			<td style="width:296px;">Qilu Pharmaceutical, Hainan, China</td>
			<td style="width:113px;">H10970065</td>
			<td>sufentanil Citrate (200ug),&#160; Ondansetron hyrochloride (20mg), adding to normal saline to a total of 80 ml, 2 ml/h</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:205px;">Parenteral nutrition&#160;</td>
			<td style="width:296px;"></td>
			<td style="width:113px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(10% glucose injection)</td>
			<td style="width:296px;">Shijiazhuang No.4 Pharmaceutical&#65292;Shijiazhuang, China</td>
			<td style="width:113px;">H20133313</td>
			<td>1000 ml</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(5% glucose&#160; injection)</td>
			<td style="width:296px;">Shijiazhuang No.4 Pharmaceutical&#65292;Shijiazhuang, China</td>
			<td style="width:113px;">H13022474</td>
			<td style="width:159px;">250 ml</td>
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		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(Compond vitamin injection)</td>
			<td style="width:296px;">Pude Pharmaceutical, Datong, China</td>
			<td style="width:113px;">H20093720</td>
			<td style="width:159px;">1 piece</td>
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		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(Compond amino acid injection)</td>
			<td style="width:296px;">Kelun Pharmaceutical, Chengdu, China</td>
			<td style="width:113px;">H20066058</td>
			<td style="width:159px;">500 ml</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutritionz(Fat emulsion injection)</td>
			<td style="width:296px;">Fresenius Kabi AB, Sweden</td>
			<td style="width:113px;">H20160019</td>
			<td style="width:159px;">250 ml</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(10%KCl injection)</td>
			<td style="width:296px;">Jinyao Pharmaceutical, Tianjin, China</td>
			<td style="width:113px;">H12020518</td>
			<td style="width:159px;">50 ml</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(10%NaCl injection)</td>
			<td style="width:296px;">CR, Double-Crane, Beijing, China</td>
			<td style="width:113px;">H11020865</td>
			<td style="width:159px;">50 ml</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:205px;">Parenteral nutrition(Insulin injection)</td>
			<td style="width:296px;">No.1 biochemical and pharmaceutical, Shanghai, China</td>
			<td style="width:113px;">H31020519</td>
			<td style="width:159px;">28 Unit</td>
		</tr>
	</tbody>
</table>

application of end-to-end anastomosis in robotic central pancreatectomy

Sentrale pancreatectomy utføres for behandling av godartet eller lav-ondartet potensielle svulst i bukspyttkjertelen halsen eller proksimale del av bukspyttkjertelen kroppen. Med teknologisk utvikling, har robot kirurgisk systemet vist sin fordel i minimal invasiv kirurgi og blitt stadig mer brukt i sentrale pancreatectomy. Imidlertid er rekonstruksjon av kontinuitet av bukspyttkjertelen med ende-til-ende anastomose etter robot sentrale pancreatectomy ikke installert. I denne studien rapporterer vi kirurgiske teknikker for robotic sentrale pancreatectomy med ende-til-ende anastomose. Bukspyttkjertelen rekonstruert ved duct-til-kanal anastomose av bukspyttkjertelen kanalens med bukspyttkjertelen stent inn i de to stumper av bukspyttkjertelen duct og ende-til-ende anastomose av bukspyttkjertelen parenchyma. Sammenlignet med tradisjonelle sentrale pancreatectomy med pancreaticoenteric anastomose, dette reduserer operative skaden til pasienten og sparer også integritet og kontinuitet av fordøyelsessystemet kanalen og bukspyttkjertelen duct. Robotic kirurgisk systemet integrert med flere instrumenter med fleksible og presise bevegelser er spesielt egnet for disseksjon og gjenoppbygging av bukspyttkjertelen røret. Vi fant at robotic sentrale pancreatectomy med ende-til-ende anastomose er trygt og gjennomførbart, og vi trenger mer erfaring å evaluere sin beste indikasjoner og langsiktige resultater.

Operasjonen prosessen var glatt. Operativ tid var 141 min intraoperativ blodtap var ca 50 mL. Størrelsen på resected bukspyttkjertelen var ca 5,5 x 2.5 × 2,5 cm (Figur 4). Pasienten utvinnes jevnt etter kirurgi og ble sluppet på 6th postoperativ dagen. Når pasienten ble sluppet, han hadde et normalt kosthold og normal avføring, og hadde ingen feber, ingen magesmerter eller distensjon. Rutinemessig blodet Eksaminasjonen og blod biokjemiske tes...

Watch this Scientific Journal Video about Application of End-to-end Anastomosis in Robotic Central Pancreatectomy at JoVE.com

Application of End-to-end Anastomosis in Robotic Central Pancreatectomy

Anvendelse av ende-til-ende anastomose i robot sentrale Pancreatectomy

Den robotic sentrale pancreatectomy med ende-til-ende anastomose er mulig og trygt for svulst i bukspyttkjertelen nakken og proksimale del av bukspyttkjertelen kroppen. Operative teknikker av operasjonen presenteres.

Central pancreatectomy is carried out for the treatment of benign or low-malignant potential tumors located in the pancreatic neck or proximal part of ...

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