经脐入路单孔腹腔镜胆囊切除术20例临床分析

Clinical analysis of 20 cases underwent laparoscopic cholecystectomy through umbilical single-port approach

目的:探讨经脐单孔腹腔镜胆囊切除术的可行性。方法:20例胆囊疾病患者(14例结石,6例息肉,)行经脐单孔腹腔镜胆囊切除术。均采用开放法在脐部做一2.0 cm弧形切口,建立腹腔镜操作通道并维持气腹完成胆囊切除。结果:20例手术均获成功。第1例手术时间为95m in,后续手术时间逐渐缩短,后3例平均40m in。均未放置引流管,无出血、感染及胆漏等并发症发生,术后平均4d出院,术后2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,虽然操作难度较常规腹腔镜胆囊切除术大,但通过熟练的操做可明显缩短手术时间,较传统LC更加微创,极具推广价值,有望成为LC的新术式。

Objective To evaluate the feasibility of laparoscopic eholecysteetomy through umbilical single - port. Method The clinical data of 20 patients with gallbladder diseases undergoing transumbilieal single - port access eholecystectomy （SPACE） was analyzed. One umbilical 2. 0 em curved incision was used. The establishment of laparoseopie operation and maintenance of pneumoperitoneum was completed through the open method. Results All the operations were successfully performed. The operation time of the first case was 95 rain. The follow - up operations＇ time gradually shortened and the last 3 cases spent 40 rain. No drainage tube was placed. Postoperative bleeding and biliary leakage didn＇t occur. The patients were discharged after average 4 days. There was no visible sear on the abdominal wall 2 weeks af- ter operation. Conclusion Transumbilieal single - port laparoscopic cholecysteetomy is a safe and feasible operation. Although the operation is more difficult than the conventional laparoscopic choleeystectomy, we can significantly shorten the operation time through skilled manipulation, It has smaller trauma than traditional operation and is worth spreading and is expected to become a new surgical procedure.