犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

样本被随机分为 2D 或 3D 组。 膀胱尿道吻合术 (VUA) 使用 5 mm 腹腔镜持针器进行。 使用单向倒钩缝合线完成 VUA，具有两个简单的连续缝合模式。 记录放置的针数、吻合口的通畅度以及 VUA 和输尿管之间的距离。

每组四只狗。 按照相同的技术在每只狗中完成前列腺切除术。 VUA 完成时，2D 组为 9 针（范围：8-10 针），3D 组为 10 针（范围：9-11 针）(p<0.176)。 所有的针迹都被放置在全厚度。 VUA 在每种情况下都是专利。 左侧输尿管距离 2D 组的 VUA 1.05 cm（范围：0.5 至 1.1 cm），而 3D 组为 1.8 cm（范围：1.3-1.8 cm）（p < 0.025）。 2D 组右侧输尿管距 VUA 1.5 cm（范围：1 至 2 cm），3D 组为 1.75 cm（范围：1.3-2 cm）（p < 0.55）。

可以使用 2D 或 3D 相机在犬尸体中进行腹腔镜根治性前列腺切除术。 3D 相机可以更准确地放置缝合线，因为它们放置在离左侧输尿管更远的地方。

应考虑对狗进行腹腔镜根治性前列腺切除术。

根治性前列腺切除术 (RP) 主要用于切除前列腺肿瘤。 据报道，狗在前列腺切除术后并发症发生率很高。 最常见的并发症是尿失禁，因此这种手术很少进行。

人类患者的腹腔镜根治性前列腺切除术 (LRP) 可显著减少主要并发症，尤其是尿失禁，因为它可以保留前列腺两侧的神经血管蒂。 腹腔镜对于消融开腹手术中难以触及的小器官是有益且更实用的。 机器人根治性前列腺切除术已在一只客户拥有的狗身上成功进行，并在三具犬尸体上进行了描述。 兽医手术中还没有现成的机器人。

膀胱尿道吻合术 (VUA) 是 RP 的重要组成部分。 它需要适当的组织对置以最大限度地减少术后渗漏并改善长期结果。 建议使用 3D 相机进行精密解剖和缝合。

研究目标是描述犬尸体腹腔镜根治性前列腺切除术的技术，并报告使用 3D 相机与 2D 相机进行腹腔镜根治性前列腺切除术。 假设使用 2D 或 3D 相机不会影响犬尸体的腹腔镜根治性前列腺切除术。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 1
处于明显的头低脚位置，用于腹腔镜根治性前列腺切除术。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 2
外部视图显示单个接入端口和两个 5 毫米插管在腹腔左右两侧的位置。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 3
A：前列腺右侧的解剖。 右侧输尿管可见（黑色箭头）。 B：用 Metzembaum 剪从右到左横切前列腺和膀胱之间的尿道。 C：尿道几乎完全横断，可见导尿管。 D：输精管已用剪刀横切。 E：左侧神经血管蒂在前列腺的每一侧都可见（黑色箭头）。 F：直肠和前列腺之间的解剖完成。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 4
A：前列腺尾部的尿道现在暴露了。 B：尿道在前列腺尾部横切。 C：尿道现已完全横切，导尿管可见。 D：VUA 在背侧进行，连续模式为 4–0 V Loc 90 缝合。 缝合线在膀胱中由外向内放置，在尿道中由内向外放置。 E：缝合背线已完成，开始腹侧缝合。 F：VUA 完成（黑色箭头）。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 5
膀胱和尿道与左 (L) 和右 (R) 输尿管一起从腹腔中取出。
测量每个输尿管和 VUA 之间的距离（黑色箭头）。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 6
沿长轴切开尿道和膀胱以观察缝合线和粘膜的并置。

犬尸体腹腔镜根治性前列腺切除术技术描述：2D 与 3D 相机

图 7
右侧神经血管束的可视化，并暴露前列腺包膜中的分支。

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