摘要
目的探讨常规器械下经脐入路单一部位腹腔镜胆囊切除术(transumbilical single-site laparoscopiccholecystectomy,TUSLC)的安全性和可行性。方法 2010年6月～2012年9月应用常规器械行TUSLC 156例。围手术期处理及手术基本操作原则同传统LC。脐旁10 mm trocar,置入腹腔镜探查腹腔,在10 mm trocar左旁直接戳孔后置入5 mm直径操作钳,在10 mm trocar右旁置入10 mm trocar作为主操作孔。左右手器械交叉操作,顺逆结合切除胆囊。结果 5例为胆囊与周围组织粘连严重,探查后即中转为传统三孔LC。余151例平均手术时间49.3 min(30～90 min),术中出血量25.7 ml(5～70 ml),肠功能恢复时间平均1.3 d(1～2 d),术后住院时间平均2.3 d(1～3 d)。156例术后随访1～24个月,平均10.8月,均无发热、腹痛、黄疸等术后胆道相关疾病症状,患者对脐部切口恢复的美容效果均满意。结论常规器械下TUSLC安全可行。
Objective To investigate the safety and feasibility of transumbilical single-site laparoscopic cholecystectomy with conventional devices.Methods The study enrolled 156 patients undergoing transumbilical single-site laparoscopic cholecystectomy with conventional devices from June 2010 to September 2012 in Shanghai Armed Police Force Hospital.Perioperative treatments and basic surgical procedures were in accordance with traditional laparoscopic cholecystectomy.We inserted laparoscope into paraumbilical 10-mm trocar for abdominal exploration,then inserted 5-mm trocar and 10-mm trocar on the left and right of umbilicus for operation forceps of 5 mm in diameter and main procedures.Anterograde combined with retrograde cholecystectomy was performed.Results Of the 156 cases,5 cases were converted to conventional LC due to severe tissue adhesion.The operation time,intra-operative blood loss,bowel function recovery time and postoperative hospital stay of the rest cases were 49.3 min（range,30-90 min）,25.7 ml（range,5-70 ml）,1.3 days（range,1-2 days） and 2.3 days（range,1-3 days）,respectively.The 156 cases were followed up for 1-24 months,with an average of 10.8 months.No postoperative complications like fever,abdominal pain and jaundice were observed among all the cases.All the patients were satisfied with the postoperative cosmetic effects.Conclusion Transumbilical single-site laparoscopic cholecystectomy with conventional devices is safe and feasible.
出处
《中国微创外科杂志》
CSCD
2013年第7期628-630,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜胆囊切除术
单一部位
经脐入路
Laparoscopic cholecystectomy
Single-site
Transumbilical access
