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首页> 外文期刊>Surgical Endoscopy >Handheld gamma probe used to detect accessory spleens during initial laparoscopic splenectomies.
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Handheld gamma probe used to detect accessory spleens during initial laparoscopic splenectomies.

机译：手持式伽马探针，用于在最初的腹腔镜脾脏切除术中检测辅助脾脏。

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BACKGROUND: Preoperative determination of the accessory spleen still is a major factor in the failure of both laparoscopic and conventional techniques. This study aimed to evaluate the practicability and efficacy of a handheld gamma probe in identifying accessory spleens at the initial intervention. METHODS: This study evaluated 17 patients undergoing laparoscopic splenectomy attributable to benign hematologic disorders. All the patients had preoperative ultrasonography, computed tomography (CT) scan, and nuclear scintigraphic examination of the abdominal cavity to assess the size of the spleen, and to determine the existence of the accessory spleen or spleens. For all the patients, a handheld gamma probe count was used intraoperatively as an adjuvant method to define the presence and location of the accessory splenic tissue. Control nuclear scintigraphic examinations of all the patients were performed 1 month after the surgical procedure. RESULTS: In two cases, intraoperatively accessory splenic tissue was detected by gamma probe, confirming the preoperative CT findings for the patients. One of these patients had three accessory spleens, although preoperative CT scan showed only two of them. However, by the help of the gamma probe, a third spleen located retroperitoneally was defined. For two patients, laparoscopic exploration and handheld gamma probe count did not identify any accessory splenic tissue, although preoperative CT scan indicated accessory spleens. For detecting accessory splenic tissue, the sensitivities of the studied techniques were 0% for ultrasonography, 75% for CT scan, 0% for preoperative nuclear scintigraphy, 75% for laparoscopic exploration, and 100% for perioperative gamma probe examination. CONCLUSION: Preoperative imaging methods for accessory spleen determination still have limited benefits because of their limited sensitivity. Thus, the handheld gamma probe technique may be an adjuvant method for laparoscopic exploration ensuring that no accessory splenic tissue is missed during the initial surgical treatment of benign hematologic disorders.
机译：背景：术前确定副脾仍然是导致腹腔镜和常规技术失败的主要因素。本研究旨在评估手持式伽马探针在初次干预时识别辅助脾脏的实用性和有效性。方法：本研究评估了17例因良性血液系统疾病而接受腹腔镜脾切除术的患者。所有患者均接受术前超声检查，计算机断层扫描（CT）扫描和腹腔核闪烁显像检查，以评估脾脏的大小，并确定是否存在副脾脏。对于所有患者，术中均使用手持式伽马探针计数作为辅助方法来确定脾附件组织的存在和位置。手术后1个月对所有患者进行对照核闪烁显像检查。结果：在2例患者中，伽马探针检测到术中副脾组织，证实了患者术前CT表现。尽管术前CT扫描仅显示其中两个，但其中一名患者有3个副脾。然而，借助于γ探针，确定了位于腹膜后的第三脾。对于两名患者，尽管术前CT扫描显示有附件脾脏，但腹腔镜探查和手持式伽马探针计数未发现任何附件性脾脏组织。对于检测副脾组织，所研究技术的敏感性为：超声检查为0％，CT扫描为75％，术前核闪烁显像为0％，腹腔镜探查为75％，围手术期伽马探针检查为100％。结论：由于敏感性有限，术前影像学检查用于确定副脾的方法仍具有局限性。因此，手持式伽马探针技术可能是用于腹腔镜探查的辅助方法，可确保在良性血液病的初始外科治疗期间不会遗漏任何脾脏附属组织。

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