腹腔镜技术研究进展及其在泌尿外科的应用

Recent advances in urologic laparoscopic surgeries

近20年来,腹腔镜技术已经广泛的应用于各种泌尿外科手术,同开放手术相比,其创伤更小、恢复更快、并发症更少。为了进一步减少术后疼痛、提升美容效果,单孔腹腔镜技术(LESS)、经自然腔道内镜手术(NOTES)已经应用于临床。LESS技术不仅能提高美容效果,还能减少术后疼痛和套管相关并发症。临床上已经试验性的完成了采用NOTES技术的经阴道途径肾切除术。而机器人技术的不断发展,不仅降低了复杂手术的技术难度、缩短了学习曲线,还使手术更趋完美。

In the past twenty years,the laparoscopic surgery had been applied in diverse urological diseases. Compared to open surgery,the laparoendoscopic operations are accompanied by minor surgical trauma,faster recovery and fewer complications.The introduction of laparoendoscopic single-site surgery(LESS)and natural orifice transluminal endoscopic surgery(NOTES)have offered reduced pain and improved cosmetic satisfaction to patients. LESS can not only improve the effect of cosmetology,but also reduce postoperative pain and trocar-related complications.Scarless nephrectomy has been realized with transvaginal natural orifice transluminal endoscopic surgery in women.The development of surgical robots has decreased the technical difficulty of complicated procedures,shortened the learning curve,and improved perioperative outcomes relative to laparoscopic surgery.