经脐单孔腹腔镜胆囊切除术

The application of transumbilical single port laparoscopic cholecystectomy

目的:探讨经脐单孔腹腔镜胆囊切除术的可行性。方法:6例胆囊疾病患者(4例息肉,2例结石)行经脐腹腔镜胆囊切除术,其中脐部做一1.5cm弧形切口,应用2种不同的方法建立腹腔镜操作通道并维持气腹完成胆囊切除。结果:6例手术均获成功。第1例手术时间为189min,后续2例手术时间约90min,后3例平均50～60min。未放置引流管,无出血及胆漏等并发症发生,清醒后即饮水,第2天出院,术后两周复查,脐部无明显手术瘢痕。结论:经脐单孔腹腔镜胆囊切除术是安全可行的,但操作难度较常规腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)大,脐部操作装置及手术器械有待进一步完善和改进,但其较传统LC更加微创,极具推广价值,可望成为有前途的新型LC。

Objective： To discuss the feasibility, methods and clinical application of transumbilical single port laparoscopic chalecystectomy. Methods ：The clinical data of 6 patients with gallbladder diseases undergoing transumbilical single port laparoscopic cholecystectomy was retrospectively analyzed. Results ： All the operation were successfully performed. The operation time of the first case was 189min,the following 2 cases 90min, and the latest 3 cases 50-60min. No drainage tube was placed and postoperative bleeding and biliary leakage didn＇t occur. The mean time of hospitalization was 1 day. There was no visible scar on the abdominal wall. Conclusions ： Transumbilical single port laparoscopic cholecystectomy is a safe and feasible operation. It has the advantages of mini-invasion ,rapid recovery, short hospitalization and cosmetic effect. It can be considered as the first choice.