单孔腹腔镜低位直肠癌保肛手术的技术要点

Surgical techniques of single incision laparoscopic sphincter-preserving operation for low rectal cancer

单孔腹腔镜技术是近年来刚刚兴起的一种微创新技术,可达到接近"无瘢痕手术"的效果,具有更好的微创和美容疗效。由于单孔的限制,手术的操作难度增加,同时在操作技巧方面也表现出一些独有的特点。单孔腹腔镜技术在结直肠手术中的应用研究相对较多,在低位直肠癌的保肛手术中可以发挥良好的微创和美容优势,但结合单孔腹腔镜技术特点及低位直肠癌的解剖结构等因素,利用单孔腹腔镜技术完成低位直肠癌的保肛手术需要充分认识和遵循其内在的规律。

Single incision laparoscopic surgery （SILS）, an emerging technique in the field of minimally invasive surgery in recent years, has been proven to be less invasive and better cosmetic and the most feasible practice as ＂no scar＂ surgery. Due to the limitation of single entrance, SILS is manipulatively difficult, while the operating skills also show some unique features. Investigative applications of SILS on colorectal surgery are increasing, exhibiting the advantages of less invasiveness and better cosmesis in the sphincter-preserving approach for low rectal cancer. Given the factors such as the novel technique of SILS and anatomical characteristics of low rectal cancer, however, it is essential to fully recognize and follow the intrinsic rules of the procedure.