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机器人全直肠系膜切除(TME)手术与腹腔镜手术的主要差异在于显露方法和常用能量器械不一致。机器人TME技术要领如下:在外科膜解剖原则指导下,在右直肠旁沟切开膜桥,进入左腹膜后间隙;沿植物神经走向,先行直肠后间隙分离,次行直肠前间隙分离,再行直肠两侧间隙分离;应距精囊腺底部0.5~1.0 cm处“U”字型横断Denonvilliers筋膜前叶,若该筋膜受癌肿侵犯,则应在其前方向下分离;分离直肠系膜至肛提肌裂孔边缘再行裸化。
The main difference between robotic total mesorectal excision (TME) surgery and laparoscopic surgery is the inconsistency between the exposure methods and the commonly used energy devices. Robot TME technical essentials are as follows: under the guidance of the principles of surgical dissection, under the guidance of the right rectal canal ditch open the diaphragm bridge, into the left retroperitoneal space; along the autonomic nervous system, the first line of rectal separation, subretinal space separation, and then The space between the two sides of the rectum should be separated; the anterior fascia of Denonvilliers should be transected from 0.5-1.0 cm from the bottom of the seminal vesicle. If the fascia is infiltrated by the tumor, it should be separated in the anterior direction; Mesenteric to levator ani muscle edge reoccupy nudity.