经脐单孔腹腔镜手术18例报告

Single-port Transumbilical Laparoscopic Surgery in Urology with Report of 18 Cases

目的:探讨经脐单孔腹腔镜手术的技术可行性、应用特点及其安全性。方法:2009年8～10月共完成18例经脐单孔腹腔镜手术,包括肾上腺肿瘤3例;肾盂癌1例;肾癌1例;肾积水致肾萎缩2例;肾盂输尿管连接部狭窄5例;输尿管上段结石2例;输尿管膀胱连接部狭窄2例;精索静脉曲张2例。结果:全部手术均成功,无一例中转开放。1例肾上腺手术由于术中出血改为标准腹腔镜手术。平均手术时间为80(30～185)min。术中未出现器官损伤并发症。术后有2例患者脐部切口愈合不良,给予相应处理恢复良好。患者平均住院时间4(3～8)天。脐部手术切口愈合后,腹壁手术瘢痕不明显。结论:经脐单孔腹腔镜手术用于复杂性泌尿外科功能重建手术和毁损性手术安全而且有效。

Objective： To explore the feasibility, efficacy and safety of single-port transumlilical laparoscopic surgery（E-NOTES） in urology. Methods：From August 2009 to October 2009, 18 urological E-NOTES operations were performed, including 3 cases of adrenal tumor, renal pelvic tumor in 1, renal cell carcinoma in 1, renal atro phy with severe hydronephrosis in 2, UPJO in 5, upper ureteral stone in 2, UBJO in 2 and varicocele in 2. Resuits：All operations were performed successfully without open conversion. Only one patient with left pheochromocytoma with size of 7cm was converted to standard laparoscopic surgery for intraoperative hemorrhage. The mean operative time was 80min （30 to 185 min）. No major complication was occurred during surgery. Abnormal incision healing were witnessed in 2 patients and recovered unevenly after proper treatment. The mean hospital stay was 4 days （3 to 8 days）. No obvious scars occurred in all patients after recovery. Conclusions： E-NOTES is feasible and effective for the reconstructive and ablative urological surgeries.