悬吊式经脐入路腹腔镜妇科手术的临床探讨

Clinical approach of suspended transumbilical single port laparoscopic gynecologic operation

目的探讨悬吊式经脐入路腹腔镜妇科手术的可行性和临床价值。方法回顾分析悬吊式经脐入路腹腔镜手术在2例宫外孕、3例卵巢囊肿、2例子宫肌瘤中应用的临床资料。结果 7例顺利完成手术。2例宫外孕手术时间平均为30min,出血量平均10mL;3例卵巢囊肿手术时间平均为55min,出血量平均30mL;2例子宫肌瘤手术时间平均为80min,出血量平均100mL。标本从脐部或阴道取出。7例手术均未放置引流,术后无出血、临近脏器损伤、尿潴留及背部疼痛,腹部疼痛轻,未用镇痛药物,腹壁无明显切口瘢痕。恢复快,宫外孕和卵巢囊肿患者术后24h后即可下床小便,3d出院;子宫肌瘤患者术后36h后下床小便,5d出院。结论悬吊式经脐入路腹腔镜妇科手术安全可行,具微创美容优势,与现代女性患者需求吻合,值得临床推广应用。

Objective To investigate the feasibility and clinical value of suspended transumbilical single port laparoscopic gynecologic operation.Methods To review and analyze the clinical data of application of suspended transumbilical single port laparoscopic gynecologic operation on 2 cases of ectopic pregnancy,3 cases of ovarian cyst and 2 cases of hysteromyoma.Results 7 patients were operated successfully.The mean operation time of 2 cases of ectopic pregnancy was 30 min,the mean intraoperative bleeding was 10mL.The mean operation time of 3 cases of ovarian cyst was 55 min,the mean intraoperative bleeding was 30mL.The mean operation time of 2 cases of hysteromyoma was 80 min,the mean intraoperative bleeding was 100mL.No drainage was placed in all 7 operations.There was no postoperative bleeding,nearby organ injured or visible scar on the abdominal wall.And also there was no uroschesis or backache,but only a little abdominal pain with no use of analgesics.The patients recovered rapidly.The patients of ectopic pregnancy and ovarian cyst could get off the bed to urinate after postoperative 24h and left the hospital on 3d after operation.The patients of hysteromyoma could get off the bed to urinate after postoperative 36h and left the hospital on5d after operation.Conclusion Suspended transumbilical single port laparoscopic gynecologic operation is feasible and safe.It has obviously superiority of minimally invasion,and also fits for the modern female patients＇ needs.It has the worth of clinical application and generalization.