Abdominal tumor resection

Abdominal wall tumor resection is the main method for treating most abdominal wall tumors. Small benign tumors can be treated by local excision and generally do not cause large and full-thickness abdominal wall defects. Treatment of diseases: abdominal fibrosarcoma Indication Benign tumors of the abdominal wall: fibroids, fibroids, neurofibromas, hemangioma, papilloma, dermoid cysts, etc. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation Before the reconstruction of the abdominal wall defect, the patient's general condition and the abdominal wall defect itself should be accurately assessed. An understanding of the patient's general condition, combined underlying disease, previous surgical history, medication history, etc. can help determine if surgery and how to perform the procedure. Surgical procedure First, the patient was placed in a supine position, and a 1 cm incision was made beside the navel. The abdominal airway needle was placed to perform peritoneal insufflation to 2 kPa. The surgical cannula was placed in the position shown and the patient was placed on the side. After the laparoscope enters the abdominal cavity, the liver, gallbladder, spleen and intestines are examined first. The lateral peritoneum of the colon was incised with an endoscopic scalpel and the colon was freed to the medial side. In order to make the renal vascular can have tension suitable for dissociation, do not cut off the junction between the lateral side of the kidney and the abdominal wall at this time, otherwise the kidney will fall to the inside and cause difficulty in renal vascular detachment. The right side of the surgery should be careful to avoid injury to the duodenum, while the left side should pay attention to the pancreas. When the renal hilum is free, the renal vein is usually separated from the front, and then the renal artery is searched for from below. When the renal artery is free from 2 to 3 cm, the blood vessel can be clamped with a large blood vessel clamp. Generally, at least 3 clips are at the proximal end and 2 clips are at the distal end. After the renal artery is severed, the renal vein is further dissociated. Because the renal vein wall is thin, especially the right renal vein is short, care should be taken to avoid severe traction and damage the junction of the inferior vena cava and the renal vein. After completely freeing the renal vein, it can be cut with an endovascular stapler (Endo GLA). If it is not easy to completely clamp the clip using only the blood vessel clip, the cut is quite dangerous. After the renal valve is treated, you should pay attention to the adrenal artery and vein. The upper pole of the kidney is then released from the liver (right) or the spleen (left). Then, the kidney is completely dissociated from top to bottom, and finally the ureter is separated. After the ureter is cut off, the whole kidney can be pulled with a tweezers, placed in a nylon bag, and then taken out. The surgical area was examined to determine that there were no other organ injuries and sutured abdominal wall cannula incision. complication abdominal pain.