目的研制免气腹内置充气式术野形成装置(laparoscopic operation field formation,LOFF)并通过动物实验应证其应用可行性。方法采用免气腹、内置、充气膨胀形成腹腔镜术野的思路,研制出中空三棱柱状LOFF操作平台。应用此平台完成7头猪...目的研制免气腹内置充气式术野形成装置(laparoscopic operation field formation,LOFF)并通过动物实验应证其应用可行性。方法采用免气腹、内置、充气膨胀形成腹腔镜术野的思路,研制出中空三棱柱状LOFF操作平台。应用此平台完成7头猪的免气腹单孔腹腔镜胆囊切除术。结果 7头猪应用LOFF平台行免气腹单孔腹腔镜胆囊切除术,6台顺利完成,术中手术平均时间为(41.33±17.68)min。1台改为双孔完成手术,术后全部存活,均无出血、胆漏等并发症。结论动物实验结果显示应用LOFF平台的免气腹单孔腹腔镜胆囊切除术是安全、可行的。展开更多
AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed datab...AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.展开更多
文摘目的研制免气腹内置充气式术野形成装置(laparoscopic operation field formation,LOFF)并通过动物实验应证其应用可行性。方法采用免气腹、内置、充气膨胀形成腹腔镜术野的思路,研制出中空三棱柱状LOFF操作平台。应用此平台完成7头猪的免气腹单孔腹腔镜胆囊切除术。结果 7头猪应用LOFF平台行免气腹单孔腹腔镜胆囊切除术,6台顺利完成,术中手术平均时间为(41.33±17.68)min。1台改为双孔完成手术,术后全部存活,均无出血、胆漏等并发症。结论动物实验结果显示应用LOFF平台的免气腹单孔腹腔镜胆囊切除术是安全、可行的。
文摘AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.
