自制单孔操作平台在经阴道单孔腹腔镜附件手术中的临床应用

Clinical application of self-made single-hole operating platform in transvaginal single-hole laparoscopic appendectomy

目的:探索采用自制单孔操作平台经阴道单孔腹腔镜附件手术的临床应用价值。方法:选择2019年10月至2020年1月入住广西医科大学第十附属医院妇科在自制单孔操作平台下行经阴道单孔腹腔镜附件手术的患者13例,收集并分析统计自制单孔操作平台的时间、患者年龄、附件肿瘤的大小、手术时间、术中出血量、术后24 h视觉模拟疼痛评分(VAS)、术后肛门排气时间和住院时间。结果:全部患者的手术均在经阴道单孔腹腔镜下顺利完成。手术时间50~90 min,平均(66.08±19.34)min;制作单孔操作平台所需时间2~5 min,平均(3.65±2.13)min,肿瘤直径8~12 cm,平均(7.32±3.55)cm;术中出血量30~100 mL,平均(44.86±35.54)mL;术后24 h VAS 1~4分,平均(1.04±0.66)分;术后肛门排气时间12~46 h,平均(28.57±7.42)h;术后住院天数2~4 d,平均(3.1±0.87)d。未发生手术并发症。结论:自制单孔操作平台具有制作方法简单的优势,且经此平台上行经阴道单孔腹腔镜手术(V-NOTES)安全可靠,适宜在基层医院推广。

Objective:To explore the clinical application value of transvaginal single-hole laparoscopic appendectomy with self-made single-hole operating platform.Methods:Thirteen patients who underwent transvaginal single-hole laparoscopic appendectomy on the self-made single-hole operating platform in our hospital from Oct.2019 to Jan.2020 were selected.The time needed to make a self-made single-hole operation platform,patient age,size of adnexal tumor,operation time,intraoperative blood loss,postoperative 24 hour visual analog pain score(VAS),postoperative anal exhaust time and the postoperative length of stay were collected and analyzed.Results:The operations of all patients were successfully performed under transvaginal single-hole laparoscopy.The average operation time was 50 to 90 min,(66.08±19.34)min.The average time needed to make a single-hole operating platform was 2 to 5 min,(3.65±2.13)min.The average diameter of tumor was 8 to 12 cm,(7.32±3.55)cm.The average intraoperative blood loss was 30 to 100 ml,(44.86±35.54)cm,and the average VAS 24 hours after operation was 1 to 4,(1.04±0.66).The average postoperative anal exhaust time was 12 to 46 hours,(28.57±7.42)hours,and the postoperative length of stay was 2 days,(3.1±0.87)days.No operative complications occurred.Conclusion:The self-made single-hole operation platform is simple and convenient,and transvaginal single-hole laparoscopic appendectomy on this platform is safe and reliable,so it is worth popularizing in the grassroots hospitals.