膜解剖理论指导下以胃后系膜为引导的胃底后壁游离在超级肥胖患者腹腔镜袖状胃切除术中的应用OACSTPCD

Objective:To explore the clinical value of utilizing the posterior gastric mesentery as a guide for the dissection of the gastric fundus posterior wall in laparoscopic sleeve gastrectomy for super obese patients,based on the principles of membrane ana-tomy.Methods:A retrospective analysis was conducted on the clinical data of 22 super obese patients who underwent laparoscopic sleeve gastrectomy guided by the posterior gastric mesentery based on membrane anatomy theory from Jan.2022 to Apr.2024.The dissection time of the posterior gastric mesentery and posterior wall of gastric fundus,intraoperative blood loss,postoperative complica-tions,hospital stay,and recovery status were recorded.Results:All 22 surgeries were successfully completed.The surface of the posterior gastric mesentery was entirely enveloped by intact membranous tissue,and after dissection,a broad posterior gastric space was created between the posterior gastric mesentery and the left gastric mesentery.The time for dissection of the posterior gastric mesentery and posterior wall of gastric fundus ranged from 11 to 16 min,with an average of(12.7±2.2)min.Intraoperative blood loss ranged from 1 to 5 mL,with an average of(2.5±1.3)mL.There was no conversion to open surgery or occurrence of postoperative gastric fistula,anasto-motic stenosis,or intra-abdominal hemorrhage.One case of incision infection and one case of pulmonary infection occurred,both were treated conservatively and resolved.The hospital stay ranged from 5 to 7 d,with an average of(5.3±1.6)d.No surgical mortality was reported.Conclusions:The use of the posterior gastric mesentery as a guide for dissection of the gastric fundus posterior wall in laparo-scopic sleeve gastrectomy,based on membrane anatomy theory,provides specific surgical guidance for super obese patients and holds significant clinical application value.