单孔腹腔镜技术在泌尿外科的初步应用

Laparoendoscopic single-site surgery for urological diseases

目的探讨单孔腹腔镜技术在泌尿外科应用方法与技巧。方法 2010年7~10月对37例患者行单孔腹腔镜手术,其中肾囊肿22例,左侧16例,右侧6例,年龄41~78岁,平均56岁;双侧精索静脉曲张15例,年龄10~32岁,平均24岁。结果所有手术均顺利完成,除2例增加了1个5 mm Trocar外,其余手术均由单孔腹腔镜完成;手术时间23~60 min,平均43 min,术后住院时间2~5 d,平均3.5 d,随访1~15个月;22例肾囊肿患者无一复发,8例术前精液异常的双侧精索静脉曲张患者术后随访3个月,5例有改善,其余患者阴囊坠胀症状均有不同程度改善。结论单孔腹腔镜治疗肾囊肿和双侧精索静脉曲张安全有效,但较标准腹腔镜难度加大,需有经验丰富的腹腔镜医师完成。

Objective To probe into the method and skill of laparoendoscopic single-site surgery（LESS） for urological diseases.Methods 37 cases were operated on LESS from July 2010 to Oct 2011.There were 22 cases of renal cyst,incuding 16 on the left and 6 on the right.The patients were 41 to 78 years old,with an average age of 56.There were 15 cases of bilateral varicoceles.The patients were 10 to 32 years old,with an average age of 24.Results All cases except 2 were achieved by LESS successfully.The operated time was 23 to 60 min,with an average time of 43 min.The length of stay was 2 to 5 d,averaged 3.5 d.All were followed-up from 1 to 15 months.Recurrence was not found in 22 cases with renal cyst.The semen mass of 5 cases of the 8 patients with abnormal preoperative bilateral varicoceles were improved.The symptom of heavy feeling in scrotum was relieved to different degrees in other patients.Conclusion Renal cyst and bilateral varicoceles can be treated by LESS,but the completion of LESS was more difficult than standard laparoendoscopic surgery,which must be carried out by the experienced laparoendoscopic doctor.