中国实用外科杂志2017，Vol.37Issue(6)：609-615,7.DOI:10.19538/j.cjps.issn1005-2208.2017.06.05
机器人和腹腔镜全直肠系膜切除术中Denonvilliers筋膜解剖的意义及技巧
The anatomical significance and surgical dissection of Denonvilliers' fascia in laparoscopic and robotic total mesorectal excision
摘要
Abstract
To dissect in the pre-rectal space is a technically difficult procedure during laparoscopic and robotic total mesorectal excision.With the further understanding of surgical membrane anatomy and the relationship between Denonvilliers' fascia and neurovascular bundles (NVB),surgeons can identify and protect the NVB during dissecting in the pre-rectal space without oncological compromise.The article introduces a surgical technique of an individual dissection of Denonvilliers' fascia.Firstly,entering the pre-Denonvilliers space by cutting the peritoneum at 1 cm anterior and cranial to the peritoneal reflection.Secondly,entering the post-Denonvilliers space by a U-shaped cut of the anterior lobe of Denonvilliers' fascia at the inner side of NVB,and at 0.5 cm away from the bottom of seminal vesicles for males or 5 cm below the peritoneal reflection for females.关键词
腹腔镜/全直肠系膜切除/Denonvilliers筋膜/血管神经束/膜解剖Key words
laparoscopic, total mesorectal excision/Denonvilliers fascia/neurovascular bundles/membrane anatomy分类
医药卫生引用本文复制引用
池畔,王枭杰..机器人和腹腔镜全直肠系膜切除术中Denonvilliers筋膜解剖的意义及技巧[J].中国实用外科杂志,2017,37(6):609-615,7.基金项目
国家临床重点专科建设资助项目(卫办医政函[2012]649号) （卫办医政函[2012]649号）
