经脐单孔腹腔镜肝囊肿开窗术

Transumbilical single-port laparoscopic liver cyst fenestration

目的 总结经脐单孔腹腔镜肝囊肿开窗术的临床应用初期经验,探讨其可行性、安全性及技术方法.方法 回顾性分析2009年11月至2010年6月解放军总医院采用经脐下缘置入3个相邻的5 mmTrocar方法,完成4例经脐单孔腹腔镜肝囊肿开窗术患者的临床资料.术中使用常规5 mm腹腔镜器械及5nm 30°腹腔镜,手术步骤同传统腹腔镜肝囊肿开窗术.结果 4例患者均顺利完成手术,其中1例联合胆囊切除,平均手术时间38 min（25～70 min）,术中无明显出血,无中转开腹或转为传统多孔腹腔镜肝囊肿开窗术.所有患者于术后1～3 d出院,住院及随访期间无任何手术相关并发症发生.结论 经脐单孔腹腔镜肝囊肿开窗术切口美观,恢复快,安全可行,但需要一定的腹腔镜手术技巧和严格掌握适应证.

Objective To determine the feasibility, safety and techniques of transumbilical single-port laparoscopic liver cyst fenestration. Methods From November 2009 to June 2010, four cases of transumbilical single-port laparoscopic liver cyst fenestration were completed through three adjacent 5 mm trocars around the umbilicus. Normal 5 mm laparoscopic instruments and a 5 mm 30° laparoscope were utilized, and the procedures were similar to conventional multi-port laparoscopic liver cyst fenestration. Results All operations were completed successfully, with no conversion to laparotomy or the multi-port laparoscopic procedure. The mean operation time was 38 minutes （25-70 minutes）. All patients were discharged at postoperative days 1-3, and no complications or cyst recurrence occurred during hospitalization and follow-up. Conclusions Transumbilical single-port laparoscopic liver cyst fenestration is safe and feasible. It has the advantages of less pain, cosmetic incision and quick recovery, but is technique-demanding.