经脐单孔腹腔镜手术在慢性顽固性便秘治疗中的作用

Role of transumbilical single port laparoscopic surgery in the treatment of chronic intractable constipation

随着腹腔镜技术的发展，单孔腹腔镜的应用越来越普遍，进一步实现了腹部无瘢痕的理想效果。我院近两年来使用经脐单孔腹腔镜应用于慢性顽固性便秘患者结肠切除手术取得了良好的疗效。本文主要介绍经脐单孔腹腔镜手术在慢性顽固性便秘治疗中的作用及开展情况。我科行单孔腹腔镜时为了尽量形成操作三角，避免器械之间的＂打架＂，遂利用切口保护器与橡胶手套制作多孔道单孔穿刺器。该＂器械＂的优势是可以给主刀医生更大的操作空间，手术过程更加便利顺畅，但橡胶手套的固定性较差，器械没有可以依靠的支点，要保证视野的清晰、稳定，对于扶镜手的要求就更高。以后随着经济的发展及器械的研发，单孔腹腔镜手术在慢性顽固性便秘的治疗中会有更广泛的应用。

With the development of laparoscopic technique, single port laparoscopic technique application is more and more common, further achieving the ideal effect without abdominal scar. Efficacy of colectomy by transumbilical single port laparoscopic surgery in treating patients with chronic intractable constipation was satisfactory in our hospital during the past two years. This paper mainly introduces the role and development of single port laparoscopic surgery in the treatment of chronic intractable constipation. In order to form the operation triangle as possible, and avoid the ＂apparatus fighting＂ between devices, incision protection device and rubber glove were used to make the multi-channel single incision puncture device. Advantages of this device can provide the surgeon with greater space to operate and more convenient operation, but owing to the poor fixation of rubber gloves and the absence of incumbent pivot in this devices, the proficiency of the camera holder is required in order to ensure a clear and stable vision. In the future, with the development of economy and equipment, single port laparoscopic surgery in the treatment of chronic intractable constipation will be used more widely.