经脐单孔腹腔镜手术212例报告

Clinical analysis of laparoendoscopic single-site surgery:with a report of 212 cases

目的:总结经脐单孔腹腔镜手术的早期应用经验,探讨其安全性及可靠性。方法:回顾分析2009年3月至2011年6月为212例患者行经脐单孔腹腔镜手术的临床资料。结果:176例成功施行经脐单孔腹腔镜胆囊切除术,其中7例因显露困难或需放置引流管中转两孔或三孔法腹腔镜手术,1例术后毛细胆管漏行开放手术。17例成功施行经脐单孔腹腔镜阑尾切除术,其中3例因粘连严重中转三孔法手术。3例行单孔腹腔镜小儿斜疝高位结扎术,4例行腹腔镜胆囊联合阑尾切除术,4例行单孔腹腔镜胆囊联合肝囊肿开窗术3,例行单孔腹腔镜精索静脉曲张高位结扎术,3例行经脐单孔腹腔镜肾囊肿去顶术2,例行经脐单孔腹腔镜胆囊联合卵巢囊肿切除术。术后脐部切口均I期愈合,脐部无可见手术瘢痕,术后随访3～27个月,无胆道损伤、胆囊床感染、出血等相关并发症发生。结论:经脐单孔腹腔镜手术安全可行,具有疼痛更轻、微创及美容效果更好等优点,是现阶段最具可行性的"No scar"技术。

Objective：To summarize the early experience of transumbilical laparoendoscopic single-site surgery and to explore the security and reliability.Methods：The clinical data of 212 cases who underwent transumbilical laparoendoscopic single-site surgery from Mar.2009 to Jun.2011 were analyzed retrospectively.Results：Transumbilical single-incision laparoscopic cholecystectomy was carried out successfully in 176 cases,of which 7 cases converted to two or three-incision laparoscopic surgery because of difficult exposure or drainage and 1 case converted to laparotomy because of leakage of capillary bile ducts.Transumbilical single-port laparoscopic appendectomy was completed in 17 cases,of which 3 cases converted to three-port surgery due to severe adhesion.Three cases of single-port laparoscopic high ligation of indirect hernia for children,4 cases of combined resection of cholecyst and appendix,4 cases of combined surgery of laparoscopic cholecystectomy and liver cyst fenestration,3 cases of high ligation of internal spermatic vein,4 cases of renal cyst unroofing and 2 cases of combined surgery of laparoscopic cholecystectomy and ovarian cystectomy were completed successfully.During the 3 to 27 months following-up,no complications such as bile duct injury,infection and bleeding of gallbladder bed occurred.No visible scar was detected.Conclusions：Transumbilical laparoendoscopic single-site surgery was feasible,have advantages of less pain,mini-invasion and better cosmetic effect.