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Study of laparoscopic anatomical features of retroperitoneal cavity around kidney and surgical access for laparoscopy
Author(s): QIU Jianguang, GAO Xin, ZHU Jianguo, ZHAN Hailun, SI Tujie, FANG Youqiang
Pages: 91-
93
Year: 2005
Issue:
2
Journal: CHINESE JOURNAL OF UROLOGY
Keyword: 腹腔镜; 肾; 解剖; 侧锥筋膜; 融合筋膜;
Abstract: 目的研究腹腔镜下肾周腹膜后隙解剖学特点,为腹腔镜手术提供解剖学依据. 方法行腹腔镜肾输尿管手术241例,通过手术录像和照片分析术中所见解剖学结构及结构间相互关系. 结果腹腔镜下可清晰观察到侧锥筋膜和融合筋膜.侧锥筋膜由腰方肌筋膜向前延伸而成,被覆于肾筋膜后叶浅面,在侧腹膜返折处向前延续为腹横筋膜;融合筋膜位于肾筋膜前叶前方,向外侧延伸并消失于侧腹膜反折前方的腹膜外组织中.肾筋膜前叶与融合筋膜之间、肾筋膜后叶与侧锥筋膜之间、腰方肌与腰大肌前方均为无血管平面.结肠外缘、腹膜和融合筋膜组成结肠外侧三角,融合筋膜、肾筋膜和侧锥筋膜形成一无血管三角区. 结论通过无血管平面的解剖学入路,可以提高手术安全性,减少出血和副损伤.建立腹腔镜下整体解剖学概念,可为手术规范的建立提供解剖学依据.
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