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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 541 -543. doi: 10.3877/cma.j.issn.1674-3946.2020.06.001

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3D腹腔镜胃癌根治术的优势与发展
黄昌明1,(), 许斌斌1, 林密1   
  1. 1. 350001 福建福州,福建医科大学附属协和医院胃外科
  • 收稿日期:2020-06-18 出版日期:2020-12-26
  • 通信作者: 黄昌明

The advantages and development of 3D laparoscopic radical surgery for gastric cancer

Changming Huang1,(), Binbin Xu1, Mi Lin1   

  1. 1. Department of Gastrointestinal Surgery, Fujian Medical University Union Hospital
  • Received:2020-06-18 Published:2020-12-26
  • Corresponding author: Changming Huang
  • About author:
    Corresponding author: Huangchangming, Email:
  • Supported by:
    National Natural Science Foundation of China(81871899); Construction Project of Fujian Province Minimally Invasive Medical Center([2017]171); Project of Fujian provincial science and technology innovation joint funding plan(2018Y9005)
引用本文:

黄昌明, 许斌斌, 林密. 3D腹腔镜胃癌根治术的优势与发展[J]. 中华普外科手术学杂志(电子版), 2020, 14(06): 541-543.

Changming Huang, Binbin Xu, Mi Lin. The advantages and development of 3D laparoscopic radical surgery for gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(06): 541-543.

腹腔镜辅助胃癌根治术自问世以来,便以其微创优势而迅速普及,但腹腔镜显像系统仅提供一个2D的手术视野,腹腔镜下手术操作难度大,且学习曲线较长。3D腹腔镜系统是近年来新兴的腹腔镜技术平台,其通过构建景深及三维立体结构,提供了真实视觉中的立体手术视野,为手术操作提供了较为精准的空间定位。在胃癌根治术中,3D腹腔镜系统有利于胃周血管裸化、淋巴结清扫,减少术中出血量,亦可能缩短初学者的学习曲线。但是,术者佩戴的偏振式眼镜使得图像分辨率降低,且目前尚缺乏该术式远期肿瘤学疗效的相关证据。未来,3D腹腔镜胃癌根治术的进一步发展仍需要更多高级别循证医学证据。

Since the advent of laparoscopic assisted radical gastrectomy for gastric cancer, it has been rapidly popularized due to its own minimally invasive advantages. However, the conventional laparoscopic imaging system could only provides a two-dimensional (2D) surgical vision, which makes it hard to delicately operate with a longer learning curve. Three-dimensional (3D) laparoscopic imaging system is a newly developed technology platform recently. It could provide a stereoscopic surgical field of vision in real vision by constructing a depth of field and a 3D structure, and could provide more accurate spatial positioning for surgical operations. In radical gastrectomy, the 3D laparoscopic system is conducive to dissect stomach blood vessels with better lymph node dissection and less intraoperative bleeding, and might shorten the learning curve for beginners. However, the polarized glasses worn by the surgeons might reduce the image resolution. In addition, currently there was no evidence about the long-term oncological efficacy of the 3D radical gastrectomy. The further development of 3D laparoscopic radical gastrectomy for gastric cancer in the future requires more high-level evidence.

图1 3D腹腔镜下幽门下区域淋巴结清扫后
图2 3D腹腔镜下胰腺上缘区域淋巴结清扫后
图3 3D腹腔镜下脾门区域淋巴结清扫后
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