经脐单孔多通道腹腔镜下肾部分切除术的初步应用  

Transumbilical laparo-endoscopic single-site partial nephrectomy:an initial clinical experience of 2 cases

作　　者：刘冰[1] 王林辉[1] 杨印辉[1] 罗文彬[1] 罗睿[1] 杨波[1] 邓震[1] 杨庆[1] 肖亮[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12期1349-1352,共4页Academic Journal of Second Military Medical University

基　　金：上海市市级医院新兴前沿技术联合攻关项目(SHDC12010115);军队临床高新技术重大项目(2010gxjs057)~~

摘　　要：目的尝试经脐单孔多通道腹腔镜下肾部分切除术,总结应用体会和手术难点。方法 2009年8月至9月对2例患者施行单孔多通道腹腔镜下肾部分切除术,均为右肾,总结手术经验和难点。结果 2例手术均顺利完成,术中增加1个5mm辅助通道以牵开肝脏。手术时间分别为255、240min,肾动脉阻断时间分别是48、40min,出血量分别为100、50ml,术中术后均未输血,未使用镇痛剂,分别于术后9、5d拔除引流管,术后住院天数分别为13、12d。结论单孔多通道腹腔镜下肾部分切除技术可行、手术安全,且瘢痕小而隐蔽,美容效果好;但临床开展需要特殊的手术器械,缝合打结操作有一定难度;右侧肾脏手术常需要辅助通道牵拉肝脏以获得良好的显露效果。Objective To summarize our experience and operative techniques of transumbilical laparo-endoscopic single-site partial nephrectomy （TLSPN）.Methods TLSPN was performed on two patients for the right kidneys in August and September of 2009.Results The operation was successfully done in both cases,with an additional trocar of 5 mm to retract the liver.The operation time was 255 min and 240 min; the time periods of renal artery occlusion were 48 min and 40 min; and the intraoperative blood losses were 100 ml and 50 ml.None of the patients received blood transfusion or antalgic.The drainage was removed 9 days and 5 days after operation,and the postoperative hospital stays were 13 and 12 days.Conclusion TLSPN is a safe and effective method with less trauma.However,special instruments are needed for the procedure,and the suture and knotting are somewhat difficult.An assistant trocar is needed for the procedure for the right kidney.

关 键 词：经脐 单孔腹腔镜 肾部分切除术 

分 类 号：R699.2[医药卫生—泌尿科学]