Clinical Research of Transumbilical Singleport Laparoscopic Treatment For Pediatric Intussusception

Objective:To explore the feasibility and clinical efficacy of single port laparoscopic surgery through the umbilical cord for the treatment of pediatric intussusception.Method:Clinical data of 38 cases of pediatric intussusception treated with umbilical single port laparoscopic surgery from December 2017 to June 2019 were collected.The surgical method involves placing Trocar through the umbilical incision to establish pneumoperitoneum,inserting a single hole with a 0°laparoscopic operating channel,exploring intussusception,and performing non-invasive forceps to completely reduce it.After the reduction of intussusception,if intestinal malformation is found,the umbilical incision can be expanded to lift the diseased intestinal tract out of the abdominal cavity for resection.At the same time,clinical data of 24 children who underwent traditional porous laparoscopic intussusception surgery during the same period were collected,and the surgical time,intraoperative blood loss,postoperative hospital stay,and satisfaction score of incision aesthetics were compared between the two groups of children.Result:Both groups of patients successfully completed the surgery,and compared with the porous laparoscopic group,the single hole laparoscopic group had a shorter surgical time[(32.4±8.6)minutes vs.(40.6±9.8)minutes,P<0.05],decreased bleeding volume[(5.5±1.5)mL vs.(8.6±2.2)mL,P<0.05],significantly shortened postoperative hospital stay[(4.6±1.2)d vs.(6.2±1.4)d,P<0.05],and significantly increased satisfaction score with incision aesthetics[(4.2±0.8)points vs.(3.2±0.7)points,P<0.05].Follow up for 6 months to 2 years showed no recurrence of intussusception.Conclusion:Transumbilical single port laparoscopic surgery is a safe and effective method for children with intussusception,which is characterized by small trauma,fast recovery,short operation time,and better aesthetic effect.

Transumbilical enterostomy for Hirschsprung’s disease with a two-stage laparoscopy-assisted pull-through procedure

BACKGROUND A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease(HD)due to its superior cosmetic results.One-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without complications.However,enterostomy is required in some HD cases for enterocolitis and dilated colon.Our transumbilical enterostomy(TUE)and twostage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation,but the effect in patients with HD is unclear.AIM To evaluate the safety,efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for HD.METHODS From June 2013 to June 2018,53 patients(40 boys,13 girls;mean age at enterostomy:5.5±2.2 mo)who underwent enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our institution.Two enterostomy approaches were used:TUE in 24 patients,and conventional abdominal enterostomy(CAE)in 29 patients.Eleven patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon.26 patients had long-segment HD,and 16 patients had total colonic aganglionosis(TCA).The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure,and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel procedure.Demographics,enterostomy operative time,complications and cosmetic results were respectively evaluated.RESULTS There were no differences between the groups with respect to gender,age at enterostomy,weight and clinical type(P>0.05).No conversion to open technique was required.Two patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group(8.33%vs 3.45%,P>0.05).No parastomal hernia was observed in either of the two groups.Wound infection at the stoma was seen in 1 case in the TUE group,and 2 cases in the CAE group(4.17%vs 6.90%,P>0.05).No obstruction was noted in any of the patients in the TUE group,whereas obstruction was found in 1 patient in the CAE group.Enterocolitis was observed in 3 and 5 patients in the TUE and CAE group,respectively(12.50%vs 17.24%,P>0.05).There was no significant difference between the TUE group and CAE group in terms of the incidence of soiling and constipation(P>0.05).The cosmetic result using the scar score in the TUE group was better than that in the CAE group(6.83±0.96 vs 13.32±1.57,P<0.05).CONCLUSION TUE is a safe and feasible method for the treatment of HD,and the staged enterostomy and two-stage laparoscopy-assisted pull-through achieved a similar cosmetic effect to the one-stage laparoscopic procedure.

Clinical feasibility of laparoscopic left lateral segment liver resection with magnetic anchor technique:The first clinical study from China

BACKGROUND Magnetic anchor technique(MAT)has been applied in laparoscopic cholecystectomy and laparoscopic appendectomy,but has not been reported in laparoscopic partial hepatectomy.AIM To evaluate the feasibility of the MAT in laparoscopic left lateral segment liver resection.METHODS Retrospective analysis was conducted on the clinical data of eight patients who underwent laparoscopic left lateral segment liver resection assisted by MAT in our department from July 2020 to November 2021.The Y-Z magnetic anchor devices(Y-Z MADs)was independently designed and developed by the author of this paper,which consists of the anchor magnet and magnetic grasping apparatus.Surgical time,intraoperative blood loss,intraoperative accidents,operator experience,postoperative incision pain score,postoperative complications,and other indicators were evaluated and analyzed.RESULTS All eight patients underwent a MAT-assisted laparoscopic left lateral segment liver resection,including three patients undertaking conventional 5-port and five patients having a transumbilical single-port operation.The mean operation time was 138±34.32 min(range 95-185 min)and the mean intraoperative blood loss was 123±88.60 mL(range 20-300 mL).No adverse events occurred during the operation.The Y-Z MADs showed good workability and maneuverability in both tissue and organ exposure.In particular,the operators did not experience either a“chopstick”or“sword-fight”effect in the single-port laparoscopic operation.CONCLUSION The results show that the MAT is safe and feasible for laparoscopic left lateral segment liver resection,especially,exhibits its unique abettance for transumbilical single-port laparoscopic left lateral segment liver resection.

Transumbilical endoscopic surgery:History,present situation and perspectives

Transumbilical endoscopic surgery or laparo-endoscopic single site(LESS)surgery has become an exciting area of surgical development as innovation continues to move in the 21st century to minimally invasive surgery.The history,present situation and perspectives are reviewed and the nomenclature of this technique is discussed in this article.The range of this technique has been applied in almost all abdominal diseases,surgeries for morbid obesity,hernia and so on,in recent years.It is estimated that 50%-80%of traditional laparoscopic surgery could be performed transumbilically in the next five years according to the LESSCAR consensus.Although the concept of transumbilical laparoscopic surgery is gaining traction rapidly and the instruments have been improved greatly, we should not advocate for slightly improved cosmetic value over safety.Multicenter,randomized and clinical trials are necessary to further elucidate the safety and efficiency of this new technique.Research that examines the efficacy of the new instruments on the market may be helpful to simplify the confusing landscape of new and novel products designed for this purpose.

Single-port laparoscopic cholecystectomy vs standard laparoscopic cholecystectomy:A non-randomized,agematched single center trial

AIM: To compare the safety of single-port laparoscopic cholecystectomies with standard four-port cholecystectomies.METHODS: Between January 2011 and December 2012 datas were gathered from 100 consecutive patients who received a single-port cholecystectomy. Patient baseline characteristics of all 100 single-port cholecystectomies were collected(body mass index, age, etc.) in a database. This group was compared with 100 age-matched patients who underwent a conventional laparoscopic cholecystectomy in the same period. Retrospectively, per- and postoperative data were added. The two groups were compared to each other using independent t-tests and χ2-tests, P values below 0.05 were considered significantly different.RESULTS: No differences were found between both groups regarding baseline characteristics. Operating time was significantly shorter in the total single-port group(42 min vs 62 min, P < 0.05); in procedures performed by surgeons the same trend was seen(45 min vs 59 min, P < 0.05). Peroperative complications between both groups were equal(3 in the single-port group vs 5 in the multiport group; P = 0.42). Although not significant less postoperative complications were seen in the single-port group compared with the multiport group(3 vs 9; P = 0.07). No statistically significant differences were found between both groupswith regard to length of hospital stay, readmissions and mortality. CONCLUSION: Single-port laparoscopic cholecystectomy has the potential to be a safe technique with a low complication rate, short in-hospital stay and comparable operating time. Single-port cholecystectomy provides the patient an almost non-visible scar while preserving optimal quality of surgery. Further prospective studies are needed to prove the safety of the single-port technique.

Technical and instrumental prerequisites for single-port laparoscopic solo surgery:state of art

With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery(SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed singleport solo surgery(SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanicaldevices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator's eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.

Laparoscopic left lateral sectionectomy in pediatric living donor liver transplantation by single-port approach:A case report

BACKGROUND Single-port laparoscopy has been used in a variety of abdominal operations.We report the first case of single-port laparoscopic left lateral sectionectomy in pediatric laparoscopic living donor liver transplantation.CASE SUMMARY A 28-year-old man volunteered for living liver donation to his daughter who was diagnosed with liver cirrhosis and portal hypertension after the Kasai procedure for biliary atresia.His body mass index was 20.5 kg/m2.Liver dynamic computed tomography showed:(1)Left lateral graft volume of 232.76 cm3 with a graft-torecipient weight ratio of 2.59%;and(2)Right hepatic artery derived from the superior mesenteric artery.A single-port access system was placed through a transumbilical incision,including four trocars:two 12-mm ports for a camera and endoscopic stapler and two 5-mm working ports.Liver parenchyma was dissected by a Harmonic and Cavitron Ultrasonic Surgical Aspirator,while bipolar was used for coagulation.The bile duct was transected above the bifurcation by indocyanine green fluorescence cholangiography.The specimen was retrieved from the umbilical incision.The total operation time was 4 h without blood transfusion.The final graft weight was 233.6 g with graft-torecipient weight ratio of 2.60%.The donor was discharged uneventfully on postoperative day 4.CONCLUSION Single-port laparoscopic left lateral sectionectomy is feasible in pediatric laparoscopic living donor liver transplantation in an experienced transplant center.

Single-port laparoscopic surgery for sigmoid volvulus

AIM:To report our experience with single-port laparoscopic surgery(SPLS)for sigmoid volvulus(SV).METHODS:Between October 2009 and April 2013,10patients underwent SPLS for SV.SPLS was performed transumbilically or through a predetermined stoma site.Conventional straight and rigid-type laparoscopic instruments were used.After intracorporeal,segmental resection of the affected sigmoid colon,the specimen was extracted through the single-incision site.Patientdemographics and perioperative data were analyzed.RESULTS:SPLS for SV was successful in all 10 patients(4,resection and primary anastomosis;6,Hartmann’s procedure).The median operative time and postoperative hospitalization period were 168(range,85-315)min and 6.5(range,4-29)d,respectively.No intraoperative complications were noted;there were 2 postoperative complications,including 1 anastomotic leak.CONCLUSION:SPLS was a safe and feasible therapeutic approach for SV,when performed by a surgeon experienced in conventional laparoscopic surgery.

Evaluation of the Single-Port Laparoscopic Right Hemicolectomy Learning Curve

Background: The use of single-port laparoscopy has gained popularity within recent years. Part of the appeal in learning this approach is that it draws heavily from concepts mastered through conventional laparoscopy. Various studies have shown the efficacy and feasibility of the single-port laparoscopic approach, but there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better define the learning curve in performing a single-port laparoscopic right hemicolectomy. Design: A review of prospectively gathered operative data was performed to analyze the results of single-port laparoscopic right hemicolectomies performed within our institution by experienced laparoscopic surgeons. The first 100 cases were divided into quintiles. Comparisons were made among the cohorts regarding patient demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions, length of stay, and number of complications did not significantly vary among each group of patients. There was a significant difference in estimated blood loss and length of stay between the fifth cohort and the others due to one patient’s poor outcome. Conclusions: The single-port laparoscopic right hemicolectomy learning curve for surgeons already skilled in laparoscopy is short. There are few differences in various outcome measures among groups at any stage in the learning curve. The skills utilized to perform conventional laparoscopic colorectal surgery readily translate to the single-port approach and result in proficiency from nearly the start.

常规器械免举宫经脐单孔腹腔镜全子宫切除术

目的探讨常规器械免举宫经脐单孔腹腔镜全子宫切除术治疗宫颈病变的应用价值。方法选择2021年12月~2023年6月因宫颈高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)或宫颈癌ⅠA1期行腹腔镜全子宫切除术60例,按患者意愿行经脐单孔腹腔镜手术及多孔腹腔镜手术各30例,均使用常规器械,不使用举宫器,比较2组手术指标。结果2组均未出现中转开腹及泌尿系、肠道或大血管等损伤。单孔组出血量较少[(54.6±20.5)ml vs.(67.5±27.0)ml,P=0.041],排气较早[(27.6±8.0)h vs.(32.2±9.0)h,P=0.040],总住院时间较短[(4.4±1.5)d vs.(5.1±1.2)d,P=0.044]。2组子宫重量、手术时间以及术后并发症差异无显著性(P>0.05)。2组切口愈合良好,未出现与穿刺器相关的近期并发症(如穿刺孔感染、出血)或远期并发症(如脐疝、切口疝)。结论免举宫经脐单孔腹腔镜全子宫切除术出血少,术后恢复快,瘢痕最小化,并发症与传统腹腔镜手术相似。

经脐单孔腹腔镜与传统腹腔镜治疗妇科良性疾病的效果对比

目的分析经脐单孔腹腔镜与传统腹腔镜治疗妇科良性疾病的方法与效果。方法选取60例妇科良性疾病患者,按照随机抽签法将其分为对照组与观察组,各30例,分别实施传统腹腔镜与经脐单孔腹腔镜治疗,对比两组手术效果。结果与对照组对比,观察组术后疼痛评分更低,术后住院时间更短,住院费用更少(P<0.05)。观察组治疗满意度96.67%较对照组的76.67%高(P<0.05)。结论经脐单孔腹腔镜治疗妇科良性疾病效果更加确切,能够提高患者手术质量与治疗满意度,值得临床推广。

经脐单孔腹腔镜体外剥除良性巨大卵巢囊肿的临床分析

目的:探讨经脐单孔腹腔镜体外剥除良性巨大卵巢囊肿的安全性和可行性。方法:回顾性分析成都市第三人民医院2021年10月至2022年9月收治的行经脐单孔腹腔镜治疗的72例良性巨大卵巢囊肿患者的临床资料,其中单孔腹腔镜体外剥除囊肿31例(单孔体外剥除组),单孔腹腔镜体内剥除囊肿41例(单孔体内剥除组),比较两组手术时间、术中气腹使用时间、术中出血量、术中囊液渗漏率、术后肛门排气时间、术后24小时疼痛程度、术后住院时间等。结果:术中囊液渗漏率单孔体外剥除组(0 vs.21.1%)明显低于单孔体内剥除组(P<0.05)。单孔体外剥除组手术时间(60.19±5.64分钟vs.72.02±6.89分钟)、术中气腹使用时间(15.23±2.69分钟vs.53.83±6.74分钟)及术后肛门排气时间(28.16±3.53小时vs.32.24±3.87小时)均短于单孔体内剥除组(P<0.05)。两组术中出血量、术后24小时疼痛视觉模拟(VAS)评分及术后住院时间比较差异无统计学意义(P>0.05)。结论:单孔腹腔镜体外剥除囊肿手术在良性巨大卵巢囊肿剥除术中可以极大程度避免术中囊液腹腔内渗漏,更加遵循手术无瘤原则,同时缩短手术时间,促进术后快速康复,此手术方式安全可行,值得临床推广。

经脐单孔腹腔镜保护卵巢功能的卵巢囊肿剥除术

目的 探讨经脐单孔腹腔镜保护卵巢功能的卵巢囊肿剥除术的经验。方法 2018年7月~2019年12月我院行56例单孔腹腔镜卵巢囊肿剥除术,术中横行切开脐部约2 cm,置入单孔套管穿刺器,建立人工气腹。超声刀避开卵巢门在其对侧切开卵巢皮质以保证良好血供,固定患侧卵巢,便于钝性分离囊肿并尽可能保留卵巢正常组织,选择2-0可吸收缝线缝合止血以及卵巢成形。结果 56例均顺利完成卵巢囊肿剥除术,其中3例双侧卵巢囊肿剥除术,3例联合输卵管切除,1例联合输卵管系膜囊肿剥除术,2例联合子宫肌瘤剔除术,1例联合阑尾切除术(因术后需腹腔引流,增加1个穿刺孔),1例联合宫腔镜子宫内膜息肉电切术,1例联合盆腔粘连松解术。手术时间(72.0±30.0)min。术后住院时间(5.0±0.6) d。无一例发生并发症。56例随访2~3年,平均1.5年,无并发症发生,无切口愈合不良,卵巢囊肿无复发。术后6、12个月与术前比较卵巢窦卵泡数差异无显著性[(7.02±1.57)个vs.(7.05±1.55)个,P=1.000;(6.93±1.46)个vs.(7.05±1.55)个,P=1.000]。术后3个月与术前比较卵巢基质血流差异无显著性(P>0.05),提示卵巢功能无减退。结论 保护卵巢功能的关键是术中合理选择手术器械与切口、精细化操作剥离卵巢囊肿以及保护卵巢的血供。

多孔与经脐单孔腹腔镜在异位妊娠行输卵管切除术患者中的应用对比

目的分析对比多孔与经脐单孔腹腔镜在异位妊娠行输卵管切除术患者中的应用效果。方法本研究以江苏省句容市妇幼保健院妇产科于2021年1月至2023年7月进行输卵管切除术治疗的异位妊娠患者作为分析对象,共52例。按手术入路的不同将患者分为对照组和研究组,各27例。对照组采取多孔腹腔镜输卵管切除术,研究组采用经脐单孔腹腔镜输卵管切除术。比较两组患者的手术时间、住院时间、术中出血量、术后肛门排气时间、术后疼痛情况、切口美观度、术后并发症发生情况。结果两组异位妊娠行输卵管切除术患者的手术时间、住院时间、术中出血量对比差异无统计学意义(P>0.05),研究组的术后肛门排气时间短于对照组(P<0.05);研究组患者术后24 h的疼痛视觉模拟评分(VAS)低于对照组,切口美观满意度高于对照组,且瘢痕自我评分(POSAS)低于对照组(P<0.05);研究组患者未发生术后出血、感染、腹腔粘连、发热并发症,对照组共发生5例,研究组术后并发症发生率低于对照组(P<0.05)。结论针对异位妊娠行输卵管切除术患者,多孔与经脐单孔腹腔镜在手术时间、术中出血量、住院时间方面的对比无明显差异,但经脐单孔腹腔镜下的输卵管手术切除的术后并发症少、感染风险小、切口更美观,让患者更满意。

经脐单孔腹腔镜下子宫动脉阻断术联合切开取胚术治疗剖宫产瘢痕部位妊娠的安全性及可行性分析

目的分析经脐单孔腹腔镜下子宫动脉阻断术联合切开取胚术在治疗剖宫产瘢痕部位妊娠(CSP)的安全性及可行性。方法选取行经脐单孔腹腔镜下子宫动脉阻断术联合切开取胚术的11例CSP患者作为研究组,行多孔腹腔镜下子宫动脉阻断术联合切开取胚术的10例CSP患者作为对照组,比较2组的基线资料及围术期相关临床数据。结果经脐单孔腹腔镜组与对照组的患者年龄、妊娠次数、剖宫产次数、距上次剖宫产时间、临床分型、停经时间以及有无阴道出血症状比较差异无统计学意义(P均>0.05)。2组的手术时间、术中出血量、术后保留导尿时间比较差异亦无统计学意义(P均>0.05)。经脐单孔腹腔镜组的术后疼痛数字等级评定量表评分低于对照组,住院时间短于对照组(P均<0.05)。结论经脐单孔腹腔镜下子宫动脉阻断术联合切开取胚术与传统多孔腹腔镜下子宫动脉阻断术联合切开取胚术相比,能减轻CSP患者术后疼痛及缩短住院时间,且安全性相当,美容效果更好,具有可行性。

经脐单孔腹腔镜在子宫肌瘤剔除术中的应用价值分析

目的分析经脐单孔腹腔镜在子宫肌瘤剔除术中的应用价值。方法98例接受子宫肌瘤剔除术治疗的子宫肌瘤患者,按照其接受术式差异分为观察组和对照组,每组49例。观察组接受经脐单孔腹腔镜子宫肌瘤剔除术,对照组接受常规多孔腹腔镜子宫肌瘤剔除术。比较两组患者手术指标(手术时间、术后排气时间、术中出血量、住院时间),术前及术后炎症因子[白细胞介素-6(IL-6)、白细胞介素-2(IL-2)]水平,术前及术后不同时间(术后24、48、72 h)视觉模拟评分法(VAS)评分,术后并发症(切口出血、切口感染、粘连型肠梗阻)发生率。结果观察组患者的手术时间(69.23±5.16)min长于对照组的(56.05±4.19)min,术后排气时间(19.62±6.35)h、住院时间(4.15±1.21)d短于对照组的(36.51±4.18)h、(5.63±0.89)d,术中出血量(102.13±20.15)ml少于对照组的(135.51±16.98)ml(P<0.05)。术后3 d,观察组患者IL-6、IL-2水平分别为(3.26±0.56)pg/ml、(26.53±6.23)ng/ml,低于对照组的(5.13±0.81)pg/ml、(36.59±5.18)ng/ml(P<0.05)。术后24、48 h,观察组VAS评分分别为(3.51±0.21)、(2.01±0.15)分,低于对照组的(4.36±0.29)、(2.36±0.21)分(P<0.05);术后72 h,两组患者VAS评分比较差异无显著性(P>0.05)。观察组患者并发症发生率为2.04%(1/49),与对照组患者的8.16%(4/49)比较差异无显著性(P>0.05)。结论对子宫肌瘤患者使用经脐单孔腹腔镜进行子宫肌瘤剔除术价值值得肯定,有助于缩短患者的住院时间和排气时间,缓解患者术后炎症反应,降低患者的术后疼痛度,且并发症发生率较低,具有一定的临床推广应用价值。

经脐单孔加一腹腔镜结直肠癌根治术治疗结直肠癌患者的效果

目的:观察经脐单孔加一(SILS+1)腹腔镜结直肠癌根治术治疗结直肠癌患者的效果。方法:回顾性分析2020年1月至2023年5月信阳市传染病医院收治的84例结直肠癌患者的临床资料,按手术方案不同将其分为研究组和对照组各42例。两组均行腹腔镜结直肠癌根治术,研究组应用SILS+1治疗,对照组采用5孔法治疗,比较两组围术期指标水平、手术前后肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)]水平、疼痛程度[视觉模拟评分法(VAS)]评分、炎性因子[γ干扰素(IFN-γ)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]水平和随访1个月的并发症发生率。结果:两组术中失血量比较,差异无统计学意义(P>0.05);研究组首次排气时间、住院时间均短于对照组,手术时间长于对照组,差异有统计学意义(P<0.05);术后1个月,两组血清CEA、CA125、CA19-9水平均低于术前,但组间比较,差异无统计学意义(P>0.05);术后1、3 d,两组VAS评分均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后1 d,两组血清IFN-γ、IL-1β、TNF-α水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经脐SILS+1腹腔镜结直肠癌根治术治疗结直肠癌患者可缩短首次排气时间和住院时间,降低炎性因子水平和疼痛程度评分,效果优于5孔法治疗,但会延长手术时间。

经脐单孔腹腔镜在子宫肌瘤剔除术中的应用效果及对切口美观度的影响

目的探讨经脐单孔腹腔镜在子宫肌瘤剔除术中的应用效果及对切口美观度的影响。方法选取2020年1月至2023年10月广东同江医院收治的60例子宫肌瘤患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各30例。对照组采用多孔腹腔镜子宫肌瘤剔除术治疗,观察组采用经脐单孔腹腔镜子宫肌瘤剔除术治疗。比较两组围手术期指标、术后疼痛程度、并发症发生情况及切口美观度。结果两组住院时间比较,差异无统计学意义(P>0.05)。观察组手术时间、肛门排气时间均短于对照组,术中出血量少于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。观察组术后6、24、48、72h视觉模拟评分法评分均低于对照组(P<0.05)。观察组切口美容量表评分高于对照组(P<0.05)。结论经脐单孔腹腔镜在子宫肌瘤剔除术中的应用效果较好,患者疼痛感轻,并发症少,切口美观度高,治疗效果显著。

经脐单孔腹腔镜手术治疗卵巢良性肿瘤的临床效果

目的:分析卵巢良性肿瘤患者采用经脐单孔腹腔镜手术治疗的临床效果。方法:选取2020年1月—2023年1月安顺市人民医院收治的卵巢良性肿瘤患者90例为研究对象,随机分为对照组和研究组,各45例。对照组采用传统多孔腹腔镜手术治疗,研究组采用经脐单孔腹腔镜手术治疗。比较两组患者手术指标、美容满意度评分、疼痛评分及术后并发症。结果:研究组手术时间、术后排气时间、下床活动时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。研究组美容满意度评分高于对照组,差异有统计学意义(P<0.001);研究组术后2、24 h、48 h视觉模拟评分均低于对照组,差异有统计学意义(P<0.001)。研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.001)。结论:与传统多孔腹腔镜手术相比,经脐单孔腹腔镜手术治疗卵巢良性肿瘤效果显著,可减轻患者术后疼痛程度,手术时间短,并发症发生率低,且术后美容满意度评分高,有助于加快患者康复速度。

Single access laparoscopic surgery:Complementary or alternative to NOTES?

In recent years,single access laparoscopic surgery(SALS) and natural orifice translumenal endoscopic surgery(NOTES) have gained interest from both clinical and industrial point of view,with the increased development of different laparoscopic instruments,production of various access ports,and improvement of operative endoscopes.The main advantages stimulating these two approaches are the cosmetic result,the rapid recovery of the patient,and the reduced need for pain killers.SALS and NOTES are in part complementary and in part alternative techniques.Currently,SALS is much simpler and technically easier than NOTES.