脐内2cm小切口单孔腹腔镜胃袖状切除术8例体会

Single 2 cm Small-incision Inside the Belly Button Laparoscopic Sleeve Gastrectomy: Experience of 8 Cases

目的探讨脐内2 cm小切口单孔腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG)的安全性、可行性,并总结手术经验。方法回顾性分析2017年5月～2018年7月于我中心行脐内2 cm小切口单孔LSG的8例肥胖患者的临床资料及随访结果,男2例,女6例,BMI 29. 4～46. 88,36. 52±10. 96。合并2型糖尿病(type 2 diabetes mellitus,T2DM) 2例。术中均采用克氏针挡肝技术。结果 8例手术均顺利完成,无术中增加戳孔或转为开放。手术时间60～120 min,(98. 7±57. 8) min,术中出血量5～50 ml,术后住院2～4 d。无戳孔感染、脂肪液化、出血、胃漏、脐疝等并发症。术后1～2个月获得随访6例。结论脐内2 cm小切口单孔LSG安全、可行,可以采用克氏针挡肝技术。

Objective To explore the safety and feasibility of single 2 em small-incision inside the belly button laparoseopic sleeve gastreetomy （LSG） and summarize the surgical experience. Methods Clinical data and follow-up results of 8 obese patients （2 males and 6 females） receiving single 2 em small-incision inside the belly button LSG from May 2017 to July 2018 were analyzed retrospectively. Their BMI were 29.4 - 46.88 （ mean, 36.52±10.96）. There were 2 cases complicated with type 2 diabetes mellitus （T2DM）. During the operation, the technology of fending off the liver by the Kirsehner wire was used. Results The operations were successfully performed in all the 8 patients without increasing the number of incision or turning to open operation. The operation time, bleeding volume, and duration of postoperative stay were 60-120 min （mean, 98.7±57.8 min）, 5-50 ml, and 2-4 d, respectively. No complications such as incision infection, fat liquefaction, hemorrhage, gastric leakage, or mnbilieal hernia were observed in all these patients. Postoperative follow-ups for 1 - 2 months were conducted in 6 cases. Conclusion Single 2 cm small- incision leakage inside the belly button LSG is safe and feasible and the technology of fending off the liver by the Kirsehner wire is necessary.