经脐入路内镜外科手术的技术难点及对策

The difficulties of the transumbilical endoscopic surgery and the countermeasures

目的：探讨经脐入路内镜手术（transumbilical endoscopic surgery,TUES）的技术难点及对策。方法：回顾分析150例TUES手术的临床资料。结果：本组经脐单孔腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）129例,经脐单孔腹腔镜阑尾切除术21例,除1例胆结石因胆囊周围严重粘连改三孔法LC外,余均经脐单孔完成,术后3-5d出院,无并发症发生。结论：开展TUES手术必须有熟练的三孔法腹腔镜手术基础,尽管有一定的难度,只要选择好手术适应证,掌握好手术技巧,可取得更加微创和美容的效果。

Objective：To investigate the difficulties of the transumbilical endoscopic surgery（TUES） and the countermeasures.Methods：The clinical data of 150 cases of TUES were retrospectively summarized and analyzed.Results：In this group,there were 129 cases of the transumbilical single-port laparoscopic cholecystectomy（LC） and 21 cases of the transumbilical single-port laparoscopic appendectomy.All cases were operated by TUES except 1 case,who was transferred to 3-port LC because of severe adhesion around gallbladder.Patients were discharged from hospital 3-5d after operation and no complications occurred.Conclusions：TUES must be based on skilled 3-port laparoscopic operation,although there are some difficulties,if the indications are exactly selected and the skills of operations are expertly mastered,there will be a more mini-invasive and cosmetic result.