经脐入路腹腔镜无疤痕胆囊切除术33例报告

Transumbilical laparoscopic cholecystectomy without visible scar:a report of 33 cases

目的：探讨经脐入路腹腔镜无疤痕胆囊切除术的可行性。方法：33例患者均于脐下穿刺5mm Trocar,置入30°腹腔镜,脐上缘做15mm切口,穿刺10mm Trocar作为主操作孔,于其右侧穿刺5mm Trocar后拔出Trocar,置入无创抓钳,完成胆囊切除术。结果：33例手术均获成功,无中转传统腹腔镜手术。手术时间平均55m in（40~85m in）,平均出血量平均12m l（8~20m l）。术中均未放置腹腔引流管,无并发症发生,术后2~3d出院。术后随访1~4个月,腹壁无可见疤痕。结论：使用传统腹腔镜器械施行经脐入路腹腔镜胆囊切除术是安全可行的,可达到腹壁无可见手术疤痕的美容效果。

Objective：To discuss the feasibility and clinical application of transumbilical laparoscopic cholecystectomy without visible scar.Methods：The 33 well-selected patients underwent transumbilical laparoscopic cholecystectomy without visible scar.A 5mm incision was made at the lower border of umbilicus and the abdominal cavity was explored with a 5mm 30° laparoscope.A 15mm incision was made at the upper border of umbilicus and a 10mm Trocar was introduced through it.Then the grasper was introduced to the right of the 10mm Trocar.Laparoscopic cholecystectomy was performed and the gallbladder was taken out through the 10mm incision.Results：All operations were performed successfully.The mean operation time was 55min（range,40-85min） and the mean blood loss was 12ml（range,8-20ml）.No drainage tube was placed and no complications occurred.The postoperative hospital stay ranged from 2 to 3 days.The follow-up period ranged from 1 to 4 months and there was no visible scar on the abdominal wall.Conclusions：Transumbilical laparoscopic cholecystectomy using conventional instruments is safe and technically feasible and without obvious abdominus scar.