Minilap杂交式经脐单孔腹腔镜胆囊切除术12例报告

Transumbilical single port laparoscopic cholecystectomy with hybrid Minilap instruments: a report of 12 cases

目的：探讨Minilap杂交式经脐单孔腹腔镜胆囊切除术的可行性与手术技≯j。方法：2013年4月至10月为8例胆囊结石、4例胆囊息肉患者施行Minilap杂交式经脐单孔腹腔镜胆囊切除术。其中7例应用自制手套单孔腹腔镜入路装置行气腹法手术；5例采用悬吊式免气腹法，以切口保护套作为入路装置，术中加用1把Minilap抓钳辅助操作。结果：12例Minilap杂交式经脐单孔腹腔镜胆囊切除术均获得成功，手术时间50～90min，平均（69．2±14．3）min；术中出血量5～15ml，平均（9．6±4．5）ml；术后住院2～4d，平均（2．5±0．8）d。术后随访1～7个月，患者恢复良好，脐部切口处于隐蔽位置，Minilap穿刺点无明显疤痕，美容效果佳。结论：Minilap杂交式经脐单孔腹腔镜胆囊切除术是安全、可行的，降低了完全单孔腹腔镜胆囊切除术的操作难度，美容效果良好。

Objective：To explore the feasibility and operation skills of transumbilical single port laparoscopic cholecystectomy with hybrid Minilap instruments. Methods：From Apr. 2013 to Oct. 2013, transmnbilical single port laparoseopie cholecystectomy with hybrid Minilap instruments was performed in twelve patients. Pneumoperitoneum and self-made single-port access device were used in seven cases, and gasless method with abdominal wall lift device and lap-protector as access device in five cases. An assisted Minilap grasper was used. Results：All the twelve cases of transumbilical single port laparoscopic cholecystectomy were successfully performed with hybrid Minilap instruments. The operative time was 50-90 min, mean （69.2 ± 14.3） min. The mean blood loss was （9.6 ± 4.5 ） ml （5-15 ml） ,and the post-operative hospital stay was （2.5±0.8） d （2-4 d）. During the 1-7 months follow-up,the patients recovered well. The umbilical incision was well hidden and the Minilap incision was nearly invisible. Conclusions ：Transumbilical single port lapa- roscopic cholecystectomy with hybrid Minilap instruments is safe and feasible with better cosmetic results and lower difficulties in totally laparoendoscopic single-site surgery techniques.