针式器械辅助下的改良单孔腹腔镜手术应用体会

Application of modified laparoendoscopic single-site surgery assisted by needlescopic instrument

目的:报告针式器械辅助下改良单孔腹腔镜手术在泌尿外科应用中的体会。方法:收集我院2011年4月~2015年12月施行针式器械辅助下改良单孔腹腔镜手术(观察组)和传统单孔腹腔镜手术(对照组)各205例,观察组包括106例腹腔镜精索静脉高位结扎术和99例经后腹腔镜肾囊肿去顶减压术;对照组例数对应相同。比较观察组和对照组患者手术时间、术中出血量、术后住院时间、术中增加辅助孔及术后并发症发生率等临床疗效指标。结果:观察组和对照组患者分别在腹腔镜和后腹腔镜两种入路下的术中出血量、术后住院时间及术后并发症方面比较差异均无统计学意义(P>0.05),但是观察组的平均手术时间短于对照组,且术中需要添加辅助孔的例数少于对照组,两组比较差异有统计学意义(P<0.05)。两组术后均无明显并发症。结论:针对一些较简单的泌尿外科腹腔镜手术,可以尝试通过针式器械辅助单孔腹腔镜手术来完成,从而降低手术难度、减少手术时间,同时使患者创伤最小化。

Objective：To study the application of needlescopic instrument assisted modified laparoendoscopic single-site surgery.Method：From April 2011 to December 2015,205 cases of modified laparoendoscopic singlesite surgery（observation group）and 205 cases of conventional laparoendoscopic single-site surgery（control group）were collected in our hospital.The observation group was consisted of 106 cases of laparoscopic high ligation in varicocele and 99 cases of retroperitoneal laparoscopic renal cyst decortication.The number of patients in the control group was the same as that of the observation group.The operation time,the amount of blood loss,postoperative hospital stay,the number of auxiliary holes and the incidence of postoperative complications were observed and compared between these two groups.Result：There were no significant difference in the amount of blood loss,the length of hospital stay and postoperative complications between these two groups under two different approaches of laparoscopic and retroperitoneal laparoscopic surgery（P〉0.05）.The average operation time of the observation group was shorter than that of the control group,and the number of patients needing additional auxiliary holes was less than that of the control group,which the difference between the two groups was statistically significant（P〈0.05）.There were no obvious complications in both two groups.Conclusion：Needlescopic instrument assisted modified laparoendoscopic single-site surgery can be used for some of the simple laparoscopic urological operations so as to reduce the difficulty of operation,reduce the operation time,and minimize trauma.