应用自制单口装置行单孔后腹腔镜泌尿外科手术(附56例报告)  

Single-site retroperitoneal laparoscopic urological surgery using the home-made single-port device(Report of 46 cases)

作　　者：史立新[1] 董隽[1] 蔡伟[1] 张旭[1] 高江平[1] 宋涛[1] 孙圣昆[1] 祖强[1] 丛冰[1] 王威[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《临床泌尿外科杂志》2012年第6期405-409,416,共6页Journal of Clinical Urology

摘　　要：目的:应用自制单口装置行单孔后腹腔镜手术治疗各种泌尿系统疾病,并验证其安全性和可行性。方法:使用自制单口装置对56例患者行单孔后腹腔镜泌尿外科手术,包括2个控制环和1个8号无粉外科手套组成一个单孔多通道操作器械,放入常规腹腔镜器械进行后腹腔镜手术。其中31例行根治性肾切除术,7例行根治性肾输尿管全长切除术,8例行肾部分切除术(包括1例同时行对侧肾上腺腺瘤切除术),4例行亲属活体供肾切取术,3例行肾上腺肿瘤切除术(包括1例同时行同侧肾囊肿去顶术),2例行肾囊肿去顶术,1例行输尿管切开取石术。患者年龄分布为30～79岁,平均54岁;男女比例为31∶25。结果:56例患者均经单孔后腹腔镜手术成功,无改行常规腹腔镜手术或开放手术。手术时间40～340min,平均141.77min;术中出血量5～600ml,平均70.8ml;住院时间6～36d,平均13.13d。无任何重大手术并发症,所有患者均表示满意。结论:应用自制单口装置行泌尿外科单孔后腹腔镜腔镜手术是安全可行的,费用低,可进一步减轻患者创伤,是一种有广阔应用前景的手术治疗方案。Abstract Objective：To present our initial experience with single-port retroperitoneal laparoscopic urological surgery using the homemade single port access iaparoscopic system for urinary system diseases, and verify the safety and feasibility of these surgery. Methods; We performed retroperitoneal laparoendoscopic urological surgery on 56 patients by using the home-made single-port device. The device include two control loops, and a powder-free surgical gloves （No 8） to form a multi-channel operation of equipment, putting conventional laparoscopic instru- ments into the abdominal cavity in surgery. of these, 31 patients underwent radical nephrectomy, 7 underwent radical resection of renal ureter, 8 underwent partial nephrectomy （including 1 case of opposite side adrenalectomymeanwhile）, 4 patients living-donor nephrectomy, 3 cases of adrenalectomy （including 1 case oi unroonng or renat cyst same side）, 2 routine renal cyst surgeries, 1 ureterolithotomy. The age distribution of patients from 30 to 79 years, an average of 54, female ratio was 31：25. Results： A total of 56 patients have undergone single-port laparo- scopic surgery, no switch to conventional laparoscopic surgery or open surgery. All cases were completed success- fully. The total operative time for the various procedures was 141.77 minutes （range 40 to 340）. The mean blood loss wasT0.80 ml （range 5 to 600） for the procedures. The hospital stay was 13.13 days （range 6 to 36） for the procedures. Without any major complications, all patients were satisfied. Conelusions： It appears to be a feasible and safe surgical strategy to perform retroperitoneal laparoscopic urological surgery using our homemade single- port device with multiple manipulation channels. It is also cost-effective. The patients will benefit from this single- port technique because only one skin scar left postoperation. It is a wide prospect method of urological surgery.

关 键 词：腹腔镜术 单孔腹腔镜 肾切除术 供肾切取术 肾部分切除术 肾上腺肿瘤切除术 

分 类 号：R572[医药卫生—消化系统]