论文部分内容阅读
临床资料 我院采取后腹腔镜手术治疗输尿管上段结石2例,均获成功。患者均为男性,年龄分别为64.69岁,均系查体发现输尿管结石。IVU示左输尿管结石合并重度肾积水,患肾显影较差。 手术方法 硬膜外麻醉或气管插管全麻,患者取侧卧位,患侧在上,于十二肋尖下方作长约2cm切口,切开皮肤和皮下组织,钝性分开肌肉,打开腰背筋膜,伸入食指扩张腹膜后间隙,置入气囊,注水800～1200ml,扩张形成腹膜后腔。放出液体,取出气囊。在手指引导下于肋缘下骶棘肌外缘及腋后线髂嵴上方分别置入直径10mm及5mm套管,第一切口处置入直径10mm套管并导入腹腔镜,注入CO_2维持腹膜后腔。经操作孔置入操作器械进行操作。在腰大肌与腹膜之间寻找输尿管,用无创伤抓钳将其钳夹提起。显露结石部位输尿管后,于结石上方固定。应用切开刀在结石部位纵行切开输尿管。将结石取出,装入套中一并拉出体外。应用带针4/0肠线间
Clinical data in our hospital to take retroperitoneal laparoscopic treatment of upper ureteral calculi in 2 cases, were successful. Patients were male, respectively, age 64.69 years old, were found in the examination of ureteral stones. IVU showed left ureteral calculi combined with severe hydronephrosis, poor kidney imaging. Surgical methods of epidural anesthesia or endotracheal intubation anesthesia, the patient take the lateral position, the affected side in the top, at the bottom of the twelve ribs for about 2cm incision, cut the skin and subcutaneous tissue, blunt muscle separation, open the waist Dorsal fascia, extending into the index finger after the expansion of retroperitoneal space, into the balloon, water 800 ~ 1200ml, the expansion of the retroperitoneal cavity. Release the fluid and remove the air bag. Under the guidance of the finger under the costal margin of the sacral spinous muscle and axillary crest iliac crest were placed 10mm and 5mm cannula, the first incision into the diameter of 10mm cannula and into the laparoscopic injection of CO_2 to maintain the retroperitoneal Cavity. The operating hole into the operating equipment to operate. Look for the ureter between the psoas muscle and the peritoneum and lift it up using a non-invasive grasper. After the ureteral stones were revealed, they were fixed above the stones. Application of incision in the stone longitudinal incision ureter. Remove the stones and pull them out of the body. Application with needles 4/0 gut