经脐单孔腹腔镜手术体会

Clinical experience of embryonic natural orifice transluminal endoscopic surgery

目的探讨经脐单孔腹腔镜手术的可行性。方法 37例患者均经脐单孔入路腹腔镜操作,完成胆囊切除26例,肝囊肿开窗术7例,阑尾切除术4例。结果 37例均顺利完成手术,平均手术时间56.6min,术后未置引流管、无出血、腹脓肿及切口感染等并发症。术后2周复查无明显脐部手术瘢痕。结论经脐单孔腹腔镜外科技术在胆囊切除、肝囊肿开窗以及阑尾切除术中的应用是安全可行的,且美容效果好,术后疼痛轻。虽然较传统腹腔镜外科技术而言存在着相对难度较大、手术器械需完善等问题,仍是一种有创新性的手术思路和方法。

[Objective] To discuss the feasibility, methods and clinical experience of embryonic natural orifice transluminal endoscopic surgery. [Methods] The 37 patients were treated by transumbilical single port laparoscopic method, 26 cases of cholecystectomies, 7 liver cyst fenestrations and 4 appendectomies were performed. [Results] All the operations were done successfully. The average operation time is about 56.6min. No drainage was placed and there were no bleeding, intra-abdominal abscess or incision infection complications. No visible scar was observed two weeks after operation. [Conclusion] The Embryonic natural orifice transluminal endoscopic surgery technique could be safely and effectively used in cholecystectomy, liver cyst fenestration, and appendectomy. It has the advantages of cosmetic and less post operation pain. Compared with classic laparoscopic surgery, the technique of E-NOTES is more difficult and the instruments still need to be mend, anyway the E-NOTES is a creative method and technique.