经脐单孔腹腔镜胆囊切除术临床技术体会

Transumbilical Single Port Laparoscopic Cholecystectomy Experience of Clinical Technology

目的经脐单孔腹腔镜手术面临的主要矛盾是两穿刺套管相近在同一水平面,术者操作冲突,和胆囊管处理问题。我们尝试用改进的器械实现了腹壁完全无可见瘢痕的经脐入路单孔腹腔镜胆囊切除术。讨论术式处理对策方法。方法我们改良的5mmtrocar及加长的电凝钩,直角钛夹钳和5mm腹腔镜。5mm钛夹钳,用上述器械我们完成了150例经脐单孔腹腔镜胆囊切除术。结果 5例因胆囊颈部结石嵌顿,胆囊明显水肿,显露困难,改用两孔法完成手术。其余均顺利完成手术,手术时间25～100min,无术中术后并发症达到腹壁无可见手术瘢痕,脐部皮肤出院时仅见脐部皱褶。结论使用我们改良的器械行经脐单孔腹腔镜胆囊切除术技术上是可行的,操作简单、安全,但必须要手术组的密切配合。

Objective Laparoscopic transumbilical single pert by the main contradiction facing the easing is similar to the two puncture in the same horizontal plane, the surgeon operating the conflict, and the cystic duct dealing with problems. We try to achieve improved device with no visible abdominal scars completely into the Road Hole by transumbilical laparoscopic choleeysteetomy.Discuss the surgical method of dealing with countermeasures.Methods We improved 5mm troear and extension of the coagulation hook, right--angle clamp and 5ram laparoscopic titanium. 5mm titanium clamp, with the equipment we have completed 150 cases of laparoscopic cholecystectomy in transumbilical single port.Results 5 cases of incarcerated due to strong gallbladder neck,cystic edema, revealed difficulties,nse two--hole method to complete the operation. The rest were successfully operated, the operation time 25N100min,no pestoperative complications to abdominal surgery without visible scars, skin transumbilieal discharge only see the transumbilical fold.Conclusion Using our improved equipment via transumbilicd single port laparoscopic eholecysteetomy is technically feasible,simple, safe,but must be dose collaboration with the surgical group.