大内脏神经(GSN)主要支配肠系膜上方内脏,切断后可有效地缓解胰性疼痛,作者介绍一种经裂孔双侧内脏神经切断方法。解剖基础:从35具尸解发现组成 GSN 的3个神经根在第10胸椎平面会合,即相当于食管裂孔的水平,约20%的 GSN 干的位置低于上述水平,该神经在右、左侧分别沿脊柱的前外侧和外侧下行,奇静脉多在其内侧,在外侧者仅1例。小内脏神经和最下内脏神经则分别支配肠系膜下方内脏和泌尿生殖器官。手术操作:脐上正中切口,用 Fruchaud 拉钩牵开肋软骨缘,牵开肝左叶、食管、主动脉和胸膜(均用特制的拉钩)。1.进入后下纵隔间隙:在内脏腹膜和 Leimer 膜作一纵形切口,游离食管,推开右 Large visceral nerves (GSN) dominate the upper viscera of the mesentery and, after being severed, can effectively relieve pancreatic pain. The authors describe a method of bilateral visceral nerve transection. Anatomical Basis: From 35 autopsy findings, three nerve roots composing GSN were found to converge on the 10th thoracic plane, which is equivalent to the level of esophageal hiatus. About 20% of the GSN dry sites were lower than the above levels. Side of the anterior and lateral descending along the spine, respectively, more azygos inside the medial, only one case of the outside. Small visceral nerves and the most visceral nerves respectively dominate the lower mesenteric organs and genitourinary organs. Surgical procedure: Incision on the umbilicus, with Fruchaud pull hook to pull off the cartilaginous margin, retract the left lobe of the liver, esophagus, aorta and pleura (both with a special pull hook). 1. After entering the lower mediastinal space: in the visceral peritoneum and Leimer film for a longitudinal incision, free esophagus, push the right