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首页> 外文期刊>Surgical Endoscopy >Gravity line strategy may reduce risks of intraoperative injury during laparoscopic surgery
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Gravity line strategy may reduce risks of intraoperative injury during laparoscopic surgery

机译：重力线策略可减少腹腔镜手术中术中受伤的风险

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摘要

Background: "Tilt" of surgical view was commonly shown on the monitor due to unintentional rotation of camera along its long axis by camera driver. Surgeons may be influenced on identification of anatomical structures by the tilt vision. We aimed to analyze the surgical records and videos of laparoscopic surgery, and to reveal the correlation between intraoperative complications and tilt view. Methods: A series of 425 consecutive patients who received laparoscopic low anterior resection and abdominoperineal resection were studied, and 398 surgery videos were reviewed. Still pictures showing intraoperative injury were selected. A method was established to measure tilt angle in the still pictures according to the reference line based on several anatomic landmarks. The patients were grouped with two methods according to different study purposes. Incidence of intraoperative complication and tilt angle were calculated, and statistical analysis was performed. Results: The incidence of intraoperative complications was 8.3 %. Tilt of the surgical field at different degrees (<15, 15 -30 and >30) was found in a relatively high rate in these surgery videos (31.4 %). Compared with controls, comparatively bigger tilt angles were found in all cases of complication group. It is interesting to note that intraoperative complications happened more often when the tilt angle was in the range of 15 -30 (72.7 %) than >30 (18.2 %). We also noted a high incidence of complication (72.7 %), while tilt angle was over 15 (26 %) in the first 100 cases; comparatively a steady declining low rate of complication occurrence (5-7 %) and also tilt angle over 15 (9-11 %) were noted in the later 298 cases. Conclusions: Rotation of camera is common during laparoscopic procedures. The tilt view increased the risk of laparoscopic procedures. Tilt angle at 15-30 is the most dangerous rotation for laparoscopic surgeries. Therefore, we propose the "Gravity Line Strategy" principle as one of the basic operating criteria to correct the tilt angle.
机译：背景：由于摄像机驾驶员意外地沿长轴旋转摄像机，因此通常在监视器上显示手术视图的“倾斜”。倾斜视觉可能会影响外科医生对解剖结构的识别。我们旨在分析腹腔镜手术的手术记录和视频，并揭示术中并发症与倾斜视角之间的相关性。方法：对425例连续接受腹腔镜低位前切除术和腹部手术切除术的患者进行研究，并回顾398例手术录像。选择显示术中损伤的静止图像。建立了一种基于几个解剖界标根据参考线测量静止图像倾斜角的方法。根据不同的研究目的将患者分为两种方法。计算术中并发症的发生率和倾斜角，并进行统计分析。结果：术中并发症发生率为8.3％。在这些手术视频中，以相对较高的比率发现了手术视野不同程度的倾斜（<15、15 -30和> 30）（31.4％）。与对照组相比，在所有并发症组中均发现相对较大的倾斜角。有趣的是，当倾斜角在15 -30（72.7％）范围内时，> 30（18.2％）发生率更高。我们还注意到并发症的发生率很高（72.7％），而在前100例中倾斜角超过15％（26％）。后来的298例患者中，并发症的发生率持续下降（5-7％），倾斜角超过15（9-11％）。结论：在腹腔镜手术中，相机旋转是常见的。倾斜视图会增加腹腔镜手术的风险。对于腹腔镜手术，倾斜角度为15-30是最危险的旋转。因此，我们提出“重力线策略”原理作为校正倾斜角的基本操作标准之一。

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