无气腹提拉直接Trocar穿刺法在腹腔镜手术中的应用分析

Analysis of the direct Trocar puncture without intraperitoneal insufflations during laparoscope

目的 介绍一种操作简单,安全快速的腹腔镜Trocar穿刺术式并探讨其临床应用价值。方法 386例腹腔镜手术以无气腹提拉法脐孔腹腔镜Trocar穿刺,132例以传统气腹针穿刺建立气腹后行脐孔或脐孔旁腹腔镜Trocar穿刺,比较两组穿刺的时间及并发症。结果无气腹提拉直接Trocar穿刺法的穿刺时间明显短于传统穿刺法,其差异具有显著统计学意义(P<0.05),而两组穿刺并发症差异无统计学意义。结论无气腹提拉直接穿刺法在脐孔腹腔镜Trocar穿刺操作简单、安全、快速、省力、易操作,值得推广。

Objective To investigate the possibility and the significance of the direct trocar puncture without intraperitoneal insufflations during laparoscope.Methods We performed a retrospective chart review of 618 patients who underwent operative laparoscopy during the study years.The time of abdominal entry and the complications of puncture were observed between 386 patients who were received the direct trocar puncture without intraperitoneal insufflations and 132 cases who were performed conventional Veress needle entry.Results The time of the first puncture of the direct trocar entry is shorter than that of the conventional Veress needle entry and the difference shows a marked statistical significance.However the complications of puncture have no statistical difference.Conclusion The direct trocar puncture of intraumbilical incision without intraperitoneal insufflations during laparoscope has many advantages such as simple,safe,short-time,high-achievement ratio and worth popularization.