泌尿外科单孔后腹腔镜手术初步体会

Initial experience of retroperitoneal laparoendoscopic single-site surgery in urology

目的探讨泌尿外科单孔后腹腔镜手术的临床价值。方法 2012年8月—2013年3月在该院行单孔后腹腔镜手术12例,其中肾囊肿去顶减压5例,输尿管上段切开取石3例,肾上腺瘤切除3例,肾癌根治术1例。患者年龄24～58岁,平均35岁。术中先以气囊扩张建立后腹膜腔,然后置入自制手套三通道套管,使用常规腹腔镜器械完成手术。结果 12例手术均成功完成,无中转开放或另外增加套管完成手术病例。手术时间45～185 min,平均115 min;术后引流管均在1～3 d拔除;术后住院时间3～7 d,平均5.5 d。12例患者术后均无明显并发症发生。结论单孔后腹腔镜手术安全可靠,临床可行,为有美容要求的患者提供了一种新的治疗选择。

Objective To evaluate the clinical value of retroperitoneal laparoendoscopic single-site surgery in urology.Methods From August 2012 to March 2013,12 patients underwent retroperitoneal laparoendoscopic single-site surgery in our hospital.5,3,3,1 underwent unroofing of renal cyst,ureterolithotomy,resection of adrenal adenoma,and radical resection of renal carcinoma respectively.The patients were 24 to 58 years old,with an average of 35.After the retroperitoneal space was set up with balloon dilatation,the homemade single-access port was set in incision.All the operations were carried out using conventional laparoscopic instruments.Results The operation was completed successfully in all the cases,no conversion into open surgery or need for additional trocar.The operative time was 45 ～ 185 min,with an average time of 115 min.The drainage tube was removed within 1 ～ 3 d.The postoperative hospitalization duration was 3 ～ 7 d,with an average time of 5.5 d.No major intraoperative or postoperative complications occurred.Conclusions Retroperitoneal single-site surgery is effective and feasible for selected patients,and it provides a new treatment option for patients with cosmetic requirements.