应用经脐单孔多通道腹腔镜技术切除猪肾的初步尝试及经验总结  

Transumbilical single-port laparoscopic nephrectomy in pigs:an initial experience

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

机构地区：[1]第二军医大学长海医院泌尿外科,上海200433

出　　处：《第二军医大学学报》2010年第4期417-420,共4页Academic Journal of Second Military Medical University

基　　金：国家科技部重大项目(20082X09312-025);上海市重点学科基金~~

摘　　要：目的尝试应用经脐单孔多通道腹腔镜技术切除猪肾,总结基本操作技巧,提高手术熟练程度,降低临床实践风险。方法采用Triport单孔系统完成10例次(5只)经腹单纯猪肾切除,总结手术操作经验,包括术中对Port的安置、左右手器械的选配、内镜的选择、基本操作手法的优化等,观察手术操作水平的变化。结果10例次手术均顺利完成,未另外增加工作通道,无周围脏器损伤等并发症发生;肾切除时间从75min缩短至23min。器械干扰是单孔腹腔镜肾切除术的难点,器械X型交叉可部分解决此问题,据此设计的4种基本操作模式避免器械干扰。结论单孔腹腔镜猪肾切除操作有助于初学者提高手术熟练程度,掌握手术技巧,缩短学习曲线,有利于降低临床实践风险。Objective To try to perform single-port laparoscopic nephrectomy in pigs,and to summarize and improve the basic skills,so as to decrease risks in clinical practice.Methods From Apr.to May 2009,we performed 10 times（5 pigs） of nephrectomy on porcine model using Triport system.The experience was summarized with respect to the following issues：the choice of endoscopy and instruments,insertion of Triport single port system,and optimization of the basic operation procedure.Results All the procedures were successful,without bleeding,organ injury or other complications.Operative time decreased from 75 min at the first time to 23 min for the last one.Clashing of instruments was the biggest frustration in the process;＂X＂shape crossing can partially resolve the problem,based on which four kinds of basic operating modes were designed.Conclusion Single-port laparoscopy nephrectomy in pigs can help the new learners to quickly improve their skills and decreases clinical risks.

关 键 词：单孔腹腔镜手术 肾切除术 基本技巧 

分 类 号：R699.2[医药卫生—泌尿科学]