经脐单切口腹腔镜下乙状结肠切除初步经验

Transumbilical single-incision laparoscopic sigmoid colectomy:early experience

目的报告经脐单孔腹腔镜乙状结肠切除术经验,探讨其特点及可行性。方法对1例女性结肠息肉患者施行经脐单孔腹腔镜下乙状结肠切除术。于脐部行2cm切口,切开皮肤和皮下组织,保留深部筋膜完整,经此切口穿刺置入3枚穿刺套管,利用常规腹腔镜手术器械完成手术操作。游离病变段乙状结肠,横行切断后将该肠段经脐部切口拖出,直视下切除病变肠段。断端送回腹腔,经肛门以吻合器完成肠管端端吻合。结果手术时间195min,术中失血50mL。患者术后恢复良好,无感染或吻合口漏等并发症出现,手术切口愈合后瘢痕不明显,美容效果良好。结论经脐单孔腹腔镜下乙状结肠切除术是方便可行的,具有良好的微创和美容效果。

[Objective] To report our experience of transumbilical single-incision laparoscopic sigmoid colectomy and to discuss its characteristics and feasibility.[Methods] A female patient with sigmoid colonic polypus was performed transumbilical single-incision laparoscopic sigmoid colectomy.A 2 cm incision was made on umbilicus and the skin and subcutaneous fat was cut open while the deep fascia is preserved.Three tracers were put into abdominal cavity through the incision and the operation was completed through these trocars with conventional instruments.After dissection the sigmoid colon segment with polypus was transected and pulled out through the umbilical incision and was removed under direct vision.The preserved end of colon was sent back into the abdominal cavity.End-to-end anastomosis was completed with circular stapler device through anus.[Results] The operating time is 195min and blood loss is 50 mL.There is no infection or leakage of anastomosis post operation.The scar of the umbilical incision is not obvious and a satisfactory cosmetic effect is achieved.[Conclusion] Transumbilical single-incision laparoscopic sigmoid colectomy is feasible and convenient and has shown obvious advantages of minimal invasion and cosmetic effects.