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Robotic laparoendoscopic single-site surgery(R-LESS) :current status in urology 被引量:4
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作者 Riccardo Autorino YANG Bo Jihad H. Kaouk 《第二军医大学学报》 CAS CSCD 北大核心 2011年第10期1050-1055,共6页
Laparoendoscopic single-site surgery(LESS)is technically challenging;it can reduces instrument triangulation and robust retraction and is associated with a steep learning curve.The instruments of the daVinci  surgic... Laparoendoscopic single-site surgery(LESS)is technically challenging;it can reduces instrument triangulation and robust retraction and is associated with a steep learning curve.The instruments of the daVinci  surgical system(Intuitive Surgical)are designed with seven degrees of motion mimicing the dexterity of the human hand and wrist.This inherent feature of the robotic arm provides superior ergonomics when performing LESS,especially for complex reconstructive surgery.This review analyzes the evidence supporting current and future application of robotic technology in the field of urologic LESS. 展开更多
关键词 摘要 编辑部 编辑工作 读者
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A Comparison between Laparoendoscopic Single-Site and Conventional Laparoscopic Renal Stone Removal Surgery: A Study of Application in Two Cases
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作者 Xingqiao Wen Yi Cai +4 位作者 Yiran Tao Baoyi Zhu Chunwei Ye Cheng Hu Yu Wang 《Open Journal of Urology》 2012年第3期147-150,共4页
Aim: To present our initial experience of applying laparoendoscopic single-site surgery (LESS) nephrolithotomy in the treatment of renal calculi. Methods: In August 2010 and April 2012, the LESS nephrolithotomy techni... Aim: To present our initial experience of applying laparoendoscopic single-site surgery (LESS) nephrolithotomy in the treatment of renal calculi. Methods: In August 2010 and April 2012, the LESS nephrolithotomy technique was applied to treat two patients with a renal calculus. One patient had a calculus measuring 5 × 3 cm, and the second patient's measured 3 × 3 cm. Both patients underwent general anesthesia. The operations were performed through a retroperitoneal approach with a single-port instrument inserted through the retroperitoneal incision. The standard laparoscopic retroperitoneal technique was performed, and the calculi were removed by incising the area of the thin renal cortex and the renal pelvis, respectively. The operating time, estimated blood loss, intraoperative complications, other complications, drainage time, and post-operative hospital stay were recorded. Results: Both procedures were completed successfully. No additional trocars were added. No conversion to standard laparoscopic or open surgery was needed. The operating times were 130 min and 120 min, and the estimated blood losses were 40 mL and 30 mL. There were no intraoperative complications. The wound drainage times were 3 d and 2 d, respectively and the post-operative hospital stays were 8 d and 7 d, respectively. There was no secondary bleeding or wound infection. Follow-up times were 2 years and 3 months, respectively. No incidence of hydronephrosis was recorded. Conclusions: LESS nephrolithotomy is safe and feasible for treating kidney calculi. It can be applied in patients with large renal calculi and regionally thin renal parenchyma. 展开更多
关键词 laparoendoscopic single-site surgery RENAL CALCULI NEPHROLITHOTOMY
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Laparoendoscopic single-site distal pancreatectomy in pigs 被引量:1
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作者 Dong Wang Zhen-Ling Ji +4 位作者 Xiao-Hua Jiang Jing-Min Wang Yu-Yan Tan Yan Wang Ya-Zhou Wen 《World Journal of Gastroenterology》 SCIE CAS 2014年第22期6878-6883,共6页
AIM: To explore the technique for laparoendoscopic single-site distal pancreatectomy.
关键词 laparoendoscopic single-site surgery LESS PANCREATECTOMY Fish hook retraction Curved laparoscopic multifunctional operative device
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Single-incision laparoscopic surgery for biliary tract disease 被引量:10
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作者 Shu-Hung Chuang Chih-Sheng Lin 《World Journal of Gastroenterology》 SCIE CAS 2016年第2期736-747,共12页
Single-incision laparoscopic surgery(SILS), or laparoendoscopic single-site surgery, has been employed in various fields to minimize traumatic effects over the last two decades. Single-incision laparoscopic cholecyste... Single-incision laparoscopic surgery(SILS), or laparoendoscopic single-site surgery, has been employed in various fields to minimize traumatic effects over the last two decades. Single-incision laparoscopic cholecystectomy(SILC) has been the most frequently studied SILS to date. Hundreds of studies on SILC have failed to present conclusive results. Most randomized controlled trials(RCTs) have been small in scale and have been conducted under ideal operative conditions. The role of SILC in complicated scenarios remains uncertain. As common bile duct exploration(CBDE) methods have been used for more than one hundred years, laparoscopic CBDE(LCBDE) has emerged as an effective, demanding, and infrequent technique employed during the laparoscopic era. Likewise, laparoscopic biliary-enteric anastomosis is difficult to carry out, with only a few studies have been published on the approach. The application of SILS to CBDE and biliary-enteric anastomosis is extremely rare, and such innovative procedures are only carried out by a number of specialized groups across the globe. Herein we present a thorough and detailed analysis of SILC in terms of operative techniques, training and learning curves, safety and efficacy levels, recovery trends, and costs by reviewing RCTs conducted over the past three years and two recently updated meta-analyses. All existing literature on single-incision LCBDE and singleincision laparoscopic hepaticojejunostomy has been reviewed to describe these two demanding techniques. 展开更多
关键词 laparoendoscopic single-site surgery LAPAROSCOPIC CHOLECYSTECTOMY LAPAROSCOPIC commonbile duct exploration LAPAROSCOPIC HEPATICOJEJUNOSTOMY single-INCISION LAPAROSCOPIC surgery
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Laparoscopic single site surgery: Experience in pediatric urology
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作者 Jonathan Wagmaister Stanislav Kocherov Boris Chertin 《World Journal of Clinical Urology》 2014年第2期119-126,共8页
Laparoendoscopic single-site surgery(LESS) has been developed to benefit patients by enabling surgeons to perform scarless surgery. In this review we aimed to summarize and critically analyze the available evidence on... Laparoendoscopic single-site surgery(LESS) has been developed to benefit patients by enabling surgeons to perform scarless surgery. In this review we aimed to summarize and critically analyze the available evidence on the current status and future prospects for LESS in pediatric urology, with special emphasis on our experience with LESS in children. The clinical data available clearly demonstrate that LESS can safely and effectively be performed in a variety of pediatric urology settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low; mostly being small case series or case-control studies from selected centers. Thus, the only objective benefit of LESS remains improved cosmetic outcome. Prospective randomized studies are awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technological advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics may be a driving force in the development of LESS. 展开更多
关键词 laparoendoscopic single-site surgery PEDIATRIC UROLOGY LAPAROSCOPY Review
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Single-site laparoscopic partial nephrectomy: Where are we going?
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作者 Roberto Castellucci Luca Cindolo +4 位作者 Mario Alvaréz-Maestro Guido Giusti Francesco Berardinelli Fabio Pellegrini Luigi Schips 《World Journal of Clinical Urology》 2014年第3期358-363,共6页
AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed datab... AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety. 展开更多
关键词 NEPHRON sparing surgery PARTIAL NEPHRECTOMY laparoendoscopic single-site surgery single-PORT access surgery single-incision laparoscopic surgery Robotic single-PORT PARTIAL NEPHRECTOMY
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Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis 被引量:7
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作者 Shu-Hung Chuang Pai-Hsi Chen +1 位作者 Chih-Ming Chang Chih-Sheng Lin 《World Journal of Gastroenterology》 SCIE CAS 2013年第43期7743-7750,共8页
AIM:To compare the clinical outcome of single-incision laparoscopic cholecystectomy(SILC)and three-incision laparoscopic cholecystectomy(3ILC)for acute cholecystitis.METHODS:From July 2009 to September 2012,136patient... AIM:To compare the clinical outcome of single-incision laparoscopic cholecystectomy(SILC)and three-incision laparoscopic cholecystectomy(3ILC)for acute cholecystitis.METHODS:From July 2009 to September 2012,136patients underwent SILC or 3ILC for acute cholecystitis at a tertiary referral hospital.One experienced surgeon performed every procedure using 5 or 10 mm 30-degree laparoscopes,straight instruments,and conventional ports.Five patients with perforated gallbladder and diffuse peritonitis and 23 patients with mild acute cholecystitis were excluded.The remaining 108 patients were divided into complicated and uncomplicated groups according to pathologic findings.Patient demography,clinical data,operative results and complications were recorded and analyzed.RESULTS:Fifty patients with gangrenous cholecystitis,gallbladder empyema,or hydrops were classified as the complicated group,and 58 patients with acute cholecystitis were classified as the uncomplicated group.Twenty-three(46.0%)of the patients in the complicated group(n=50)and 39(67.2%)of the patients in the uncomplicated group(n=58)underwent SILC;all others underwent 3ILC.The postoperative length of hospital stay(PLOS)was significantly shorter in the SILC subgroups than the 3ILC subgroups(3.5±1.1 d vs 4.6±1.3 d,P<0.01 in the complicated group;2.9±1.1 d vs 3.7±1.4 d,P<0.05 in the uncomplicated group).The maximum body temperature recorded at day 1 and at day 2 following the procedure was lower in the SILC subgroups,but the difference reached statistical significance only in the uncomplicated group(37.41±0.56℃vs 37.80±0.72℃,P<0.05 on postoperative day 1;37.10±0.43℃vs 37.57±0.54℃,P<0.01 on postoperative day 2).The operative time,estimated blood loss,postoperative narcotic use,total length of hospital stay,conversion rates,and complication rates were similar in both SILC and 3ILC subgroups.The complicated group had longer operative time(122.2±35.0 min vs 106.6±43.6 min,P<0.05),longer PLOS(4.1±1.3 d vs 3.2±1.2 d,P<0.001),and higher conversion rates(36.0%vs 19.0%,P<0.05)compared with the uncomplicated group.CONCLUSION:SILC is safe and efficacious for patients with acute cholecystitis.The main benefit is a faster recovery than that achieved with 3ILC. 展开更多
关键词 single-INCISION LAPAROSCOPIC CHOLECYSTECTOMY single-INCISION LAPAROSCOPIC surgery Laparoen doscopic single site surgery CHOLECYSTECTOMY Acute CHOLECYSTITIS COMPLICATED CHOLECYSTITIS Gangrenous CHOLECYSTITIS
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Transurethral assistant transumbilical laparoendoscopic single-site radical prostatectomy 被引量:3
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作者 Chen Zhu Jian Su +6 位作者 Lin Yuan Yang Zhang Zi-Jie Lu Yun Su Ning-Hong Wang Xiao-Jian Gu Qing-Yi Zhu 《Asian Journal of Andrology》 SCIE CAS CSCD 2017年第4期473-476,共4页
The laparoendoscopic single-site (LESS) technique is the latest technical innovation in laparoscopic surgery to undergo exponential development in urology. This study undertaken to illustrate our initial experience ... The laparoendoscopic single-site (LESS) technique is the latest technical innovation in laparoscopic surgery to undergo exponential development in urology. This study undertaken to illustrate our initial experience LESS radical prostatectomy (RP) and analyze early outcomes. Nineteen patients diagnosed with prostate cancer underwent LESS-RP in our institute. The patients were divided into two groups: conventional LESS and transurethral assistant LESS. Preoperative, perioperative, postoperative, pathologic, and functional outcomes data were assessed. With the help of a transurethral assistant, the mean operation and anastomosis time were decreased markedly. No focal positive margins were encountered. No prostate-specific antigen recurrence was detected 1 month postoperatively. Complete continence recovery (no pad) was observed in 32% of the patients at 1 month after the operation. No intraoperative and postoperative complications were reported, LESS-RP is a feasible and effective surgical procedure for treatment of prostate cancer. Moreover, transurethral assistant LESS could reduce the difficulty of LESS-RP and shorten the operation time. 展开更多
关键词 laparoendoscopic single-site surgery prostate cancer transurethral assistant
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Laparoendoscopic single-site radical prostatectomy: technique and initial outcomes 被引量:2
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作者 ZHU Gang ZHANG Ya-qun +8 位作者 Philippe Grange Kilian Walsh JIN Bin ZHANG Yao-guang CHEN Xin WANG xuan WEI Dong WAN Ben WANG Jian-ye 《Chinese Medical Journal》 SCIE CAS CSCD 2012年第21期3815-3820,共6页
Background Laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a challenging urological procedure and needs to be further evaluated. This study was undertaken to illustrate the safety and initial... Background Laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a challenging urological procedure and needs to be further evaluated. This study was undertaken to illustrate the safety and initial results of pure LESS-RP with conventional available instruments. 展开更多
关键词 prostate neoplasms laparoendoscopic single-site surgery radical prostatectomy
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Preliminary experience with transperitoneal laparoendoscopic single-site radical nephrectomy using a home-made single-port device in China
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作者 Bi Hai Ma Lulin Hou Xiaofei Zhang Shudong Wang Guoliang Zhao Lei 《Chinese Medical Journal》 SCIE CAS CSCD 2014年第2期279-283,共5页
Background Laparoendoscopic single-site (LESS) surgery represents a technique to further reduce morbidity and scarring associated with surgery.We present our preliminary experience with transperitoneal LESS radical ... Background Laparoendoscopic single-site (LESS) surgery represents a technique to further reduce morbidity and scarring associated with surgery.We present our preliminary experience with transperitoneal LESS radical nephrectomy (RN) using a home-made single-port device in China.Methods From July 2010 to November 2011,eleven patients with renal tumor not greater than T2 underwent LESS-RN by an experienced laparoscopic surgeon.A home-made single-port device was used through a 5-cm umbilical incision.A combination of standard and articulating laparoscopic instruments was used.The sequence of steps of LESS-RN was similar to transperitoneal laparoscopic RN.Patient characteristics,perioperative variables and postoperative outcomes were recorded and analyzed.Results Except for two transperitoneal laparoscopic conversions and one hand-assisted laparoscopic conversion,the other procedures were completed successfully without conversion to open surgery.The mean operative time was 224.5 (155-297) minutes,estimated blood loss was 270.9 (50-900) ml,and hospital stay was 10.4 (5-15) days.The mean visual analog pain scale (VAPS) on the first postoperative day was 4.0/10.Final pathological analysis revealed renal cell carcinoma in all cases with a stage distribution of three T1a,five T1b,and three T2a tumors.With the mean followup period of 21.4 (12-28) months,all patients were alive without evidence of tumor recurrence or metastasis,and were satisfied with the appearance of the scars.Conclusion Transperitoneal LESS-RN using a home-made single-port device is technically feasible and safe in a selected group of patients (low body mass index and stage tumor) and has excellent cosmetic results.Although preliminary oncologic outcome is not compromised,the long-term evaluation of these patients is awaited. 展开更多
关键词 renal cell carcinoma laparoendoscopic single-site surgery NEPHRECTOMY
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LESS-OPEN理念创新及其在卵巢囊肿剥除中的应用和展望
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作者 王延洲 谭文唯 《陆军军医大学学报》 CAS CSCD 北大核心 2024年第19期2165-2170,共6页
卵巢囊肿是妇科最常见的疾病之一,腹腔镜手术是治疗良性卵巢肿瘤的重要手段,单孔腹腔镜手术(laparoendoscopic single-site surgery,LESS)因将瘢痕隐藏于肚脐而备受女性患者的青睐,而单孔腹腔镜结合开腹手术(open surgery)有望在保证美... 卵巢囊肿是妇科最常见的疾病之一,腹腔镜手术是治疗良性卵巢肿瘤的重要手段,单孔腹腔镜手术(laparoendoscopic single-site surgery,LESS)因将瘢痕隐藏于肚脐而备受女性患者的青睐,而单孔腹腔镜结合开腹手术(open surgery)有望在保证美观的同时,降低手术难度,更好的保留卵巢功能。本团队在国内首创了单孔腹腔镜联合开腹手术(LESS-OPEN)理念,在卵巢囊肿的治疗上取得了很好的疗效,并在国际上率先构建了单孔腹腔镜体外(LESS-E)卵巢囊肿剥除术可行性预测评分系统,在此基础上建立了卵巢囊肿LESS-E手术适应证体系。本述评旨在讨论LESS-OPEN理念在卵巢囊肿剥除中的应用,并对该项技术的发展进行展望。 展开更多
关键词 单孔腹腔镜联合开腹 卵巢囊肿剥除术 应用 展望
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郑氏4C悬吊法经脐单孔腹腔镜手术治疗宫颈癌的疗效及预后分析
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作者 何秋敏 张崇媛 +1 位作者 张思思 胡尧 《局解手术学杂志》 2024年第2期162-165,共4页
目的探讨郑氏4C悬吊法经脐单孔腹腔镜手术(TU-LSSS)治疗宫颈癌的疗效,并分析其预后。方法选取我院收治的宫颈癌患者92例,并随机分为对照组(传统腹腔镜术)和观察组(郑氏4C悬吊法TU-LSSS),每组46例。比较2组患者围术期相关指标。随访3年,... 目的探讨郑氏4C悬吊法经脐单孔腹腔镜手术(TU-LSSS)治疗宫颈癌的疗效,并分析其预后。方法选取我院收治的宫颈癌患者92例,并随机分为对照组(传统腹腔镜术)和观察组(郑氏4C悬吊法TU-LSSS),每组46例。比较2组患者围术期相关指标。随访3年,记录患者无进展生存期(PFS)和总生存期(OS),并分析预后的影响因素。结果与对照组比较,观察组患者手术时间更长(P<0.05),术中出血量更少(P<0.05),术后肠鸣音恢复时间、住院时间更短(P<0.05),术后3年PFS率、3年OS率更高(P<0.05)。随访3年,疾病进展或死亡共11例。经单因素分析,预后良好组与预后不良组患者肿瘤直径、临床分期、淋巴结转移、脉管浸润、治疗方法比较,差异有统计学意义(P<0.05);二元Logistic回归分析显示,肿瘤直径(≥4 cm)、临床分期(≥ⅠB2期)、淋巴结转移、脉管浸润是宫颈癌预后的危险因素(P<0.05),郑氏4C悬吊法TU-LSSS是保护因素(P<0.05)。结论郑氏4C悬吊法TU-LSSS治疗宫颈癌可有效促进患者恢复,提高3年PFS率和OS率。预后与多种因素有关,需根据不同危险因素给予针对性处理。 展开更多
关键词 郑氏4C悬吊法 经脐单孔腹腔镜手术 宫颈癌 疗效 预后
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机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术:全球首例报道(附视频)
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作者 沈百欣 倪斌 +6 位作者 张俊麒 郑明 魏勇 薛珺 杨昕 朱清毅 顾民 《机器人外科学杂志(中英文)》 2024年第2期233-237,共5页
南京医科大学第二附属医院泌尿外科于2023年5月收治1例“左侧供肾”患者,完成了首例机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术,该术式国内外尚无相关报道。手术顺利完成,未增加额外切口,术前机器人定位时间8 min,手术时间83 m... 南京医科大学第二附属医院泌尿外科于2023年5月收治1例“左侧供肾”患者,完成了首例机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术,该术式国内外尚无相关报道。手术顺利完成,未增加额外切口,术前机器人定位时间8 min,手术时间83 min,术中出血20 ml,热缺血时间3 min,冷缺血时间131 min。供肾动脉长3.5 cm,静脉长5.1 cm,输尿管长15 cm。皮肤切口长度为6 cm。供者术后复查肾功能正常,无任何围手术期并发症,术后3 d出院。肾移植术中再通血流后,移植肾色泽良好,张力正常,30 s后即有尿液流出,受者术后2 d血肌酐降至正常,未出现移植肾功能延迟恢复。结果表明,机器人辅助经腹膜后入路单孔腹腔镜下活体供肾切取术具有安全、可靠、创伤小、恢复快、体表切口美观等优势,具有良好的临床应用前景。 展开更多
关键词 单孔腹腔镜手术 机器人辅助手术 供肾切取术 活体供肾 肾移植
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妇科经脐单孔腹腔镜手术并发症的预防及处理河南专家共识
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作者 乔明静 杨立 +18 位作者 徐臻 任芳 李睿 熊丽丽 韩听锋 赵维楠 李素红 权丽丽 刘现红 周传亚 刘秀玲 牛爱琴 于鹤 赵玉杰 杨君 王虹 郭哲 任琛琛 王悦 《河南医学研究》 CAS 2024年第23期4225-4229,共5页
随着微创理念在妇科手术中应用不断发展,其手术技术水准和学科建设水平也在不断提高。腹腔镜技术作为一种微创手术方式,以其创伤小、住院时间短、术后恢复快等优点成为妇科治疗的基本术式。单孔腹腔镜手术技术基于近年来兴起的自然孔道... 随着微创理念在妇科手术中应用不断发展,其手术技术水准和学科建设水平也在不断提高。腹腔镜技术作为一种微创手术方式,以其创伤小、住院时间短、术后恢复快等优点成为妇科治疗的基本术式。单孔腹腔镜手术技术基于近年来兴起的自然孔道内镜手术的基本理念。针对单孔腹腔镜手术技术在技术规范的前提下,保证医疗安全及治疗效果,河南省医学会妇产科分会经自然腔道内镜学组参考现有文献及结合河南省妇科经脐单孔腹腔镜手术术者自身经验制定了本专家共识。本文就妇科经脐单孔腹腔镜手术并发症的预防及处理进行了河南省区域技术规范的阐述,旨在降低妇科经脐单孔腹腔镜手术并发症的发生率,促进河南省区域妇科经脐单孔腹腔镜技术的良好发展。 展开更多
关键词 妇科经脐单孔腹腔镜 并发症 预防及处理 专家共识
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经阴道自然腔道内镜手术与经脐单孔腹腔镜手术在治疗肥胖患者子宫良性病变的效果比较
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作者 李文元 魏民 +9 位作者 韩婕 李瑞锋 王珍 李海兰 许静 靳冬梅 徐凌燕 彭容 张衍 孙新华 《实用医学杂志》 CAS 北大核心 2024年第22期3184-3189,共6页
目的通过比较肥胖患者子宫良性病变时经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,vNOTES)与经脐单孔腹腔镜手术(laparoendoscopic single-site surgery,LESS)的全子宫切除术的效果,探讨vNO... 目的通过比较肥胖患者子宫良性病变时经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,vNOTES)与经脐单孔腹腔镜手术(laparoendoscopic single-site surgery,LESS)的全子宫切除术的效果,探讨vNOTES在肥胖患者子宫良性病变的应用价值。方法选取2022年1月至2023年1月妇科肥胖患者(BMI>28.0 kg/m^(2))因良性病变需行全子宫加双侧输卵管切除术100例,按照随机数字表法将患者分为LESS组51例、vNOTES组49例。比较患者一般资料、手术时间、术中出血量、血红蛋白变化情况、疼痛评分、术后首次肛门排气时间、住院时间、盆底功能情况、性生活质量及术后并发症等情况。结果2组患者在出血量、手术前后血红蛋白变化、盆底功能情况、性生活质量以及术后并发症方面差异无统计学意义(P>0.05)。而vNOTES组手术时间、肛门首次排气时间、住院时间均短于LESS组(P<0.05),同时vNOTES组术中疼痛评分小于LESS组(P<0.05)。结论在肥胖的子宫良性病变患者中vNOTES子宫切除术手术时间和术后住院时间更短,术后疼痛评分更低,更符合快速康复外科的理念,值得进一步推广。 展开更多
关键词 经阴道自然腔道内镜手术 经脐单孔腹腔镜手术 肥胖 子宫良性病变
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经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗先天性巨结肠临床研究
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作者 胡海 林明辉 +5 位作者 李伟 雷德政 陈嘉波 孙全凤 陈鹏 罗意革 《腹部外科》 2024年第4期281-286,共6页
目的探讨经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗儿童先天性巨结肠(Hirschsprung’s disease,HSCR)的疗效。方法回顾性分析广西医科大学第一附属医院2014年1月至2019年12月收治的163例HSCR患儿临床资料,按手术方法的不同分为经脐单孔... 目的探讨经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗儿童先天性巨结肠(Hirschsprung’s disease,HSCR)的疗效。方法回顾性分析广西医科大学第一附属医院2014年1月至2019年12月收治的163例HSCR患儿临床资料,按手术方法的不同分为经脐单孔腹腔镜辅助短肌鞘斜形吻合(TU-LEES)组和传统腹腔镜保留长肌鞘(CLS)组,比较两组的手术时间、术中出血量、术后住院时间、肠管功能恢复时间、术中并发症、术后并发症的情况及术后瘢痕情况。结果两组手术均能顺利完成。CLS组中转开放手术3例,TU-LESS组需扩大脐部切口2例。TU-LESS组术后小肠结肠炎、吻合口狭窄的发生率均低于CLS组(均P<0.05),术后半年TU-LESS组瘢痕美容评估与评级量表小于CLS组(P<0.05),其余观察指标两组无统计学差异(均P>0.05)。结论经脐单孔腹腔镜辅助短肌鞘斜形吻合术治疗HSCR的方法安全可行,美容效果优于常规腹腔镜手术,吻合口狭窄及小肠结肠炎的发生率低于常规腹腔镜Soave手术。 展开更多
关键词 先天性巨结肠 经脐单孔腹腔镜 改良Soave短肌鞘术式 SOAVE手术
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三种腹腔镜手术在异位妊娠治疗的临床对比研究
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作者 赵玲 王亦雄 +2 位作者 张磊 尚教伟 林莎莎 《中国现代医生》 2024年第13期21-24,共4页
目的比较经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,v-NOTES)、经脐单孔腹腔镜手术(transumbilical laparoendoscopic single site surgery,TU-LESS)及传统腹腔镜手术治疗异位妊娠的疗效... 目的比较经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,v-NOTES)、经脐单孔腹腔镜手术(transumbilical laparoendoscopic single site surgery,TU-LESS)及传统腹腔镜手术治疗异位妊娠的疗效与差异。方法回顾性选取2019年6月至2022年6月扬州大学医学院附属扬州市妇幼保健院收治的异位妊娠患者121例,根据手术方式不同将纳入患者分为传统腹腔镜组(49例)、TU-LESS组(43例)和v-NOTES组(29例)。观察各组患者的年龄、体质量指数(body mass index,BMI)、血红蛋白(hemoglobin,Hb)、手术时间、术中出血、术后排气时间、术后24h视觉模拟评分法(visual analogue scale,VAS)评分、术后住院时间和满意度。结果v-NOTES组患者的排气时间、术后住院时间均显著短于传统腹腔镜组和TU-LESS组,术后24h VAS评分显著低于传统腹腔镜组和TU-LESS组(P<0.05);三组患者的术后满意度比较差异有统计学意义(H=57.364,P<0.001),且v-NOTES组>TU-LESS组>传统腹腔镜组。结论与TU-LESS和传统腹腔镜手术比较,v-NOTES治疗异位妊娠术后恢复快,疼痛轻,更加美观,但需要手术者熟练掌握。 展开更多
关键词 经阴道自然腔道内镜手术 经脐单孔腹腔镜手术 传统腹腔镜手术 异位妊娠
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达芬奇机器人SP系统在泌尿外科的应用与发展
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作者 魏勇 沈露明 +5 位作者 刘威 孟旭辉 胡海斌 沈百欣 杨昕 朱清毅 《机器人外科学杂志(中英文)》 2024年第3期307-311,共5页
达芬奇机器人SP系统是一种智能化微创手术系统,其立体化、精准化的优势将有助于完成高难度、复杂手术。达芬奇机器人SP系统是单孔领域的一大助力,并已广泛应用于泌尿外科。与传统开腹手术相比,微创手术具有缩短住院时间和加速患者术后... 达芬奇机器人SP系统是一种智能化微创手术系统,其立体化、精准化的优势将有助于完成高难度、复杂手术。达芬奇机器人SP系统是单孔领域的一大助力,并已广泛应用于泌尿外科。与传统开腹手术相比,微创手术具有缩短住院时间和加速患者术后恢复等优势。为了减少手术切口,并在一定程度上满足现代美学要求,单孔腹腔镜手术(LESS)在临床应用甚广,但LESS在一定程度上存在器械间相互干扰,影响手术操作,进而限制了LESS在临床的进一步应用,这就要求符合美学概念和对器械三维关系影响小的新器械出现。因此更符合人体构造学及更具三维立体感的达芬奇机器人SP系统应运而生。达芬奇机器人SP系统规避了LESS的一些风险,并结合了达芬奇机器人系统与单切口的优势,近年来被广用于泌尿外科领域,本文就达芬奇机器人SP系统在泌尿外科领域的发展和应用进行综述。 展开更多
关键词 机器人辅助手术 单孔机器人 泌尿外科 单孔腹腔镜手术
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达芬奇Xi手术机器人辅助单孔腹腔镜治疗早产低体重儿十二指肠梗阻:全球首例报道(附手术视频)
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作者 胡涛 高贺云 +5 位作者 张文 李庚 宋学敏 张静 赵国艳 何秉燕 《机器人外科学杂志(中英文)》 2024年第4期747-750,756,共5页
本文报道了2023年4月武汉大学中南医院小儿外科应用达芬奇Xi手术机器人辅助单孔腹腔镜治疗新生儿十二指肠梗阻1例,术中同时完成两处异位胰腺病灶切除。患儿胎龄35-1w,剖宫产,出生体重2090 g,出生后50 h进行手术。手术机器人操作时间76 m... 本文报道了2023年4月武汉大学中南医院小儿外科应用达芬奇Xi手术机器人辅助单孔腹腔镜治疗新生儿十二指肠梗阻1例,术中同时完成两处异位胰腺病灶切除。患儿胎龄35-1w,剖宫产,出生体重2090 g,出生后50 h进行手术。手术机器人操作时间76 min,术中出血量约5 ml,术后6 d试进水,术后8 d开奶,并逐步恢复至母乳喂养,间断复查腹部彩超3次,未见明显异常,术后16 d痊愈出院。 展开更多
关键词 机器人辅助单孔腹腔镜手术 早产低体重儿 十二指肠梗阻 环状胰腺
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妇科经自然腔道单孔手术发展现状与未来方向 被引量:2
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作者 张春花 关小明 《中国临床新医学》 2024年第6期601-606,共6页
经自然腔道单孔内镜手术创伤小,美容效果好,术后康复快,并发症发生率低,符合现代无瘢痕、无痛的微创理念,是妇科微创外科的发展方向。妇科经自然腔道单孔内镜手术主要分为经脐入路与经阴道入路。经阴道入路腹部无瘢痕,切口愈合快,术后... 经自然腔道单孔内镜手术创伤小,美容效果好,术后康复快,并发症发生率低,符合现代无瘢痕、无痛的微创理念,是妇科微创外科的发展方向。妇科经自然腔道单孔内镜手术主要分为经脐入路与经阴道入路。经阴道入路腹部无瘢痕,切口愈合快,术后疼痛程度低,并发症发生率低,是目前妇科微创手术的研究热点。近年来,机器人手术系统快速发展,与经自然腔道单孔内镜手术结合可实现三维成像放大术野,灵活的机械臂实现复杂手术操作,拓宽了手术适应证,提高了手术精准度,被认为是微创手术的革命性突破。该文就妇科经自然腔道单孔手术发展现状与未来方向进行阐述。 展开更多
关键词 妇科 单孔腹腔镜手术 经自然腔道内镜手术 机器人辅助单孔腹腔镜手术
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