免钛夹针孔式腹腔镜胆囊切除术463例报道

Needlescopic clipless cholecystectomy-a study of 463 cases

目的探讨免钛夹针孔式腹腔镜在早期胆囊良性疾患切除术的应用价值。方法采用免钛夹针孔穿刺锥鞘和器械对符合手术指征的胆囊良性疾患行胆囊切除术463例。手术方法:建立气腹后,置3个trocar,2个为3 mm,1个为10 mm;胆囊管、动脉的解剖与免钛夹结扎离断,切除后的胆囊及胆石的取出方法改进等。结果 463例均获成功,无并发症发生,疗效满意。结论针孔式腹腔镜使切口更小、更美观、术后恢复更快;免钛夹消除了钛夹对人体的不良影响;免钛夹针孔式腹腔镜在早期胆囊良性疾患切除术的应用是安全的,是更进一步趋向微创外科的新技术。

Objective To investigate the value of Needlescopic clipless cholecystectomy in the early benign gallbladder disease. Methods Four hundred sixty-three consecutive patients who underwent needlescopic clipless cholecystectomy were analyzed. Surgical technique： after performing the pneumoperitoneum at the umbilical site, 3 trocars were inserted; 2 of 3 mm and 1 of 10mm in diameter, through which a laparoscope was inserted. Neither the 3 mm laparoscope, nor clips were used. The cystic artery and duct were safely ligated near the gallbladder neck with surgical knots. Removal of the gallbladder was carried out in an adapted endobag through the 10 mm umbilical site. Results four hundred sixty-three consecutive patients had undergone Needlescopic elipless chole- cystectomy successfully. No complications were observed, and postoperative results are superior to conventional laparoscopic surgery. Conclusion The incision of Needlescopic clipless cholecystectomy was nearly invisibe, and postoperative recovery was faster; free titanium clip eliminate adverse effects on the human body; Our results indicate that this procedure could be performed successfully and safely by experienced surgical teams.