经脐单孔多通道腹腔镜手术治疗良性肾脏疾病的初步体会  

Single-port transumbilical laparoscopic surgery for the treatment of benign renal diseases： initial experience

作　　者：孙颖浩[1] 王林辉[1] 杨波[1] 许传亮[1] 肖亮[1] 刘冰[1] 杨庆[1] 徐斌[1] 王辉清[1] 

机构地区：[1]第二军医大学附属长海医院泌尿外科,上海200433

出　　处：《中华泌尿外科杂志》2009年第11期728-730,共3页Chinese Journal of Urology

摘　　要：目的探讨经脐单孔多通道腹腔镜手术治疗良性肾脏疾病的可行性和安全性。方法2008年12月至2009年5月，应用Triport单孔多通道平台完成无功能肾切除1例、肾盂旁囊肿1例和单纯性肾囊肿去顶减压术11例。在脐上缘切开2cm，开放切开法直接进入腹腔．置入Triport。使用5mm一体式腹腔镜、可弯抓钳、可弯分离钳和传统腹腔镜器械完成操作。使用血管直线切割器离断肾蒂。无功能肾脏标本装袋后由切口取出，不留置引流管。结果手术均顺利完成，未增加另外工作通道。其中肾切除术耗时85min，出血50ml；肾盂旁囊肿去顶术耗时110min，出血30ml；单纯性肾囊肿去顶术平均耗时35（25-5）min。术后平均住院2．8（2～5）d，术后均无明显手术瘢痕。结论经脐单孔多通道腹腔镜手术治疗良性肾脏疾病创伤小、美容效果好，效果满意，在适应可弯器械后手术难度明显减低。Objective To evaluate the safety and efficacy of single-port transumbilical laparoscopic surgery for the treatment of benign renal diseases. Methods From December 2008 to May 2009, 13 cases of benign renal disease were treated with Tri-Port system single-port transumbilical laparoseopic surgery, including nonfunctional nephrectomy （1 ease）, decortication of simple renal cyst （11 cases） and porapelvic cyst （1 case）. Tri Port placed from a transumbilieal incision was used in all cases. A flexible grasper and a 5-mm 30-degree camera were used in addition to standard laparoseopic equipment or flexible scissors. Renal pediele was secured and divided by Endoscopic Linear＇Stapling. Nonfunctioning kidney was extracted through the transumbilical incision without leaving drainage. Results All surgeries were completed successfully, no conversion to standard laparoscopic approach and no additional trocar added. The operative time of nonfunctional nephrectomy was 85 min and estimated blood loss was 50 ml. The operative time of decortication of parapelvie cyst was 110 min and estimated blood loss was 30 ml. The mean operative time of decortication of simple renal cyst was 35 min. The mean hospital stay after surgery was 2.8 d. Conclusions Single-port laparoseopic surgery is safe and feasible in the treatment of benign renal diseases. It has the advantages of less trauma and more cosmetic benefit than traditional laparoscopie surgery. However, more specific instruments and longer learning curving need to improve the skills during the single-port surgery.

关 键 词：腹腔镜 单孔 脐 良性 肾疾病 

分 类 号：R686[医药卫生—骨科学]