探讨Habib 4X在腹腔镜脾部分切除术中的应用价值。

回顾性分析2013年12月至2019年6月在南方医科大学顺德医院应用Habib 4X行腹腔镜脾部分切除术的10例患者临床资料。患者均签署知情同意书，符合医学伦理学规定。其中男2例，女8例；年龄18～67岁，中位年龄46岁。10例均为脾脏单发病灶，病灶直径2.0～13.0 cm，中位直径5.2 cm。术中应用Habib 4X逐次、渐进地沿着缺血线对脾组织进行充分消融凝固，再用超声刀联合电凝铲沿凝固带离断脾实质。观察患者围手术期情况及预后。

10例均应用Habib 4X顺利完成腹腔镜脾部分切除术，无中转开腹。手术时间90～190 min，中位时间125 min；术中出血量30～100 ml，中位出血量65 ml，术中均未输注血制品；围手术期无死亡病例，无发生腹腔出血、感染、胰瘘、残留脾梗死等术后严重并发症。术后病理学检查示脾脏上皮性囊肿4例，脾脏海绵状血管瘤3例，脾脏淋巴管瘤2例，脾脏血管淋巴管瘤1例。术后住院时间为6～11 d，中位时间8 d。术后随访1～67个月，中位随访时间30个月，随访期间无发生并发症。

Habib 4X应用于腹腔镜脾部分切除术是安全、可行、有效的。

To explore the application value of Habib4X in laparoscopic partial splenectomy.

Clinical data of 10 patients who underwent laparoscopic partial splenectomy with Habib 4X from December 2013 to June 2019 in Shunde Hospital of Southern Medical University were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 2 patients were male and 8 female, aged 18-67 years old with a median age of 46 years old. All 10 cases were diagnosed with a single lesion in the spleen. The lesion diameter was ranged from 2.0 to 13.0 cm with a median diameter of 5.2 cm. Intraoperatively, Habib 4X was applied to gradually ablate and coagulate the spleen tissues along the ischemic line, and then the spleen was separated along the coagulation zone using ultrasonic scalpel and electrocoagulation forceps. Perioperative condition and prognosis of the patients were observed.

All 10 patients underwent laparoscopic partial splenectomy successfully with Habib 4X device without conversion to open surgery. The operation time was 90-190 min with a median time of 125 min. Intraoperative blood loss was ranged from 30 to 100 ml with a median volume of 65 ml. No blood transfusion was performed during the operation. No perioperative death or severe postoperative complications, such as abdominal hemorrhage, infection, pancreatic fistula and residual spleen infarction, were observed. Postoperative pathological examination demonstrated that 4 cases were with splenic epithelial cyst, 3 splenic cavernous hemangioma, 2 splenic lymphangioma and 1 splenic angiolymphangioma. The length of postoperative hospital stay was 6-11 d with a median length of 8 d. Postoperative follow-up endured from 1 to 67 months with a median duration of 30 months. No complications occurred during postoperative follow-up.

Habib 4X device is safe, feasible and effective in laparoscopic partial splenectomy.