门诊局麻下微型腹腔镜精索内静脉丝线高位结扎术的临床应用

CLINICAL APPLICATION OF MINI-LAPARIOSCOPIC VARICOCELE LIGATION BY SILK SUTURE INOUTPATIENTS UNDER LOCAL ANESTHESIA

为了改变泌尿外科精索静脉曲张患者需住院→开刀→抗菌→拆线→出院等传统治疗模式 ,也为了改变常规腹腔镜需全麻、费用高、体内残留有金属异物的状况 ,我们自拟麻醉药配方、剂量、给药时间 ,应用直径4mm微型腹腔镜 ,用丝线高位结扎精索内静脉 ,切开的后腹膜用丝线缝合关闭 ,避免术后出血、粘连。患者不住院 ,术后即可返家。临床应用 31例 ,全部在局麻下完成手术 ,术时未见明显出血及脏器损伤 ,无 1例中转手术 ,术后精索静脉曲张均消失 ,Valsalva法检查阴性。提示该术式在临床上是可行的 ,是一种医患都乐意接受的新术式。

Objective: An increasing number of operative procedures in urology can be performed by laparoscopy. We report our experience with mini-laparoscopic varicocele ligation by silk suture, which is a typical operative in outpatients and a simple technique for suture ligation. Methods: Mini-laparoscopic varicocele ligation by silk suture was performed in 31 outpatients (12 to 37 years olds, 10 bilateral and 21 unilateral) since Nov.1993. With the patient under local anesthesia the pneumoperitoneurn was induecd, three-4mm-trocars were inserted, the spermatic vein was ligtured by silk suture and the retroperitoneum was sutured by silk suture. Results: All operations were completed as planned under local anesthesia. Blood loss was more minimal and there were no intraoperative or postoperative complications. Mean postoperative hospital stay is 2 hours. All patients are in out patients. Conclusions: Mini-laparoscopic varicocele ligation is feasible and minimally invasive. Its procedure can be performed in outpatients and it's an effective and simple treatment for varicocele.