普通器械经脐入路腹腔镜联合手术的临床应用

Clinical application of transumbilical laparoscopic combined surgery with ordinary instruments

目的 探讨普通器械经脐入路腹腔镜联合手术的方法及疗效.方法 应用普通腹腔镜器械经脐入路行腹腔镜联合手术28例,其中经脐入路腹腔镜胆囊切除术联合肝囊肿开窗引流术2例,阑尾切除术19例,粘连松解术2例,附件切除术2例,右侧输卵管切除术1例,精索静脉高位结扎术2例.结果 28例应用普通腹腔镜器械经脐入路行腹腔镜联合手术均获成功,无中转开腹手术.手术时间50～160 min,平均（85±23.6） min,术中出血10 ～40 mL,12 h后开始进流质饮食,术后住院3～9d,平均（4.5±1.4）d.患者均痊愈出院,随访1～24个月,无近期及远期并发症.结论 普通腹腔镜器械经脐入路腹腔镜联合手术具有一次麻醉和手术完成多个病变部位治疗的优点,手术安全、有效,切口美观,值得临床推广应用。

Objective To explore the procedure and efficacy of transumbilical laparoseopie combined surgery with ordinary instruments. Methods 28 patients underwent transumbilical laparoseopic combined surgery with ordinary instruments. Cholecystectomy combined with fenestration and drainage of hepatic cyst was performed in 2 cases, eholeeysteetomy combined with appendectomy in 19 cases, cholecysteetomy com- bined with adhesiolysis in 2 cases, eholecystectomy combined with adnexeetomy in 2 cases, eholecystectomy combined with fight salpingectomy in one case, and cholecystectomy combined with high ligation of spermatie vein in 2 cases. Results Transumbilical laparoseopie combined surgery with ordinary instruments was com- pleted successfully in all cases. There was no conversion to open surgery. The average operation duration was （85 ±23.6） min [range, （50- 160） mini. The average intraoperative blood loss was 10 -40mL. All pa- tients were provided with a liquid diet 12 hours after the surgery. The average postoperative hospital stay was （4.5 ± 1.4） d [ range, （3 - 9） d ]. The patients discharged after complete recovery. No short-term and long-term complications occurred during the follow-up of 1 to 24 months. Conclusions In the transumbilical laparoscopic combined surgery with ordinary instruments, treatment for multiple lesions can be accomplished during one operation with one anesthesia. It is a safe and effective surgical approach with cosmetic incisions, and is worthy of application and promotion in clinical practice.