经脐单孔腹腔镜治疗肾输尿管疾病的应用体会  

Single-port transumbilical laparoscopic surgery for kidney and ureter disease

作　　者：李刚[1] 孙光[1] 权昌益[1] 蔡启亮[1] 刘志虎[1] 郝海峰[1] 李晓时[1] 胡兵[1] 王久威[1] 牛远杰[1] 

机构地区：[1]天津医科大学第二医院,天津300211

出　　处：《腹腔镜外科杂志》2011年第6期419-421,共3页Journal of Laparoscopic Surgery

摘　　要：目的：总结经脐单孔腹腔镜治疗肾脏输尿管疾病的手术经验,并探讨其可行性。方法：2009年8月至2011年1月采用自制多通道单孔设备为6例无功能积水肾脏患者行肾切除术、为12例输尿管上段结石患者行输尿管切开取石术。术中所用的自制通道由两个环和一个无菌手套制作而成。取脐旁2 cm切口,置入自制多通道,将普通器械与可弯器械相配合,完成肾切除或肾盂输尿管切开取石术,切除标本由脐部切口取出。结果：17例顺利完成单孔腹腔镜手术,1例因术中腹主动脉损伤而中转开放手术。手术时间平均（123.3±23.4）min,术中平均出血（86.5±12.4）ml,平均住院7d,术后平均留置引流管3.5d。术后随访2~14个月,脐部切口愈合良好,无脐疝等并发症发生。结论：采用自制的多通道设备行经脐单孔腹腔镜手术治疗上尿路病变安全可行,切口瘢痕隐蔽,具有良好的美容和微创效果,为上尿路疾病的治疗提供了新的选择。Objective：To summarize the experience of single-site transumbilical laparoscopic surgery for kidney and ureter disease and explore its feasibility.Methods：From Aug.2009 to Jan.2010,with self-made multi-channel single-port equipment,6 cases of non-functioning kidney patients and 12 cases of ureteral calculi patients underwent laparoscopic single-site transumbilical surgery.2cm peri-umbilical incision was made,self-made multi-channel single-port equipment,common laparoscopic equipment and flexible operating equipments were inserted into the abdominal cavity and specimens was removed from the umbilical incision.Results：Seventeen laparoscopic single-port operations were completed successfully.The mean operative time was（123.3±23.4）min,mean blood loss was（86.5±12.4）ml.1 case with abdominal aortic injury was converted to open surgery.The mean postoperative hospital stay was 7d,mean duration of drainage catheter was 3.5d,the patients were followed up 2-14 months,during which no complications occurred.Conclusions：The laparoscopic single-site transumbilical surgery for upper urinary tract lesions is safe and feasible,scar hidden,has good cosmetic results and can be a new clinical treatment method.

关 键 词：肾疾病 输尿管结石 腹腔镜检查 单孔 

分 类 号：R699[医药卫生—泌尿科学]