杂交式经脐单孔腹腔镜脾切除术6例报告  

Hybrid transumbilical single port laparoscopic splenectomy:a report of 6 cases

作　　者：张光永[1] 王磊[1] 刘少壮[1] 展翰翔[1] 李峰[1] 胡春晓[1] 刘腾[1] 刘新农[1] 胡三元[1] 

机构地区：[1]山东大学齐鲁医院,山东济南250012

出　　处：《腹腔镜外科杂志》2013年第3期163-167,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨杂交式经脐单孔腹腔镜脾切除术的可行性、安全性、实用性及优缺点。方法:2011年11月至2012年12月为6例患者(免疫性血小板减少性紫癜4例、遗传性球形红细胞增多症2例)施行杂交式经脐单孔腹腔镜脾切除术。4例应用自制单孔腹腔镜入路装置,2例应用SILS入路装置。6例均采用左腋前线肋缘下2 cm处辅助5 mm切口,通过此孔留置引流管。结果:6例杂交式经脐单孔腹腔镜脾切除术均获成功,手术时间150～225 min,平均(189.2±31.8)min;术中出血量50～200 ml,平均(108.3±58.5)ml;术后住院6～9 d,平均(7.2±1.2)d。术后随访3～14个月,患者恢复良好,脐部切口位置隐蔽,美容效果佳。结论:杂交式经脐单孔腹腔镜脾切除术安全、可行,具有更佳的美容效果。但此手术难度较高,应严格把握适应证。Objective ： To explore the feasibility, safety, practicality, advantages and disadvantages of hybrid transumbilical sin- gle port laparoseopic splenectomy. Methods ：From Nov. 2011 to Dee. 2012, hybrid transumbilieal single incision spleneetomy was per- formed in six patients;four cases were immune thrombocytopenie purpura and two cases were hereditary spheroeytosis. Self-made single port device was used in four cases and SILS accessing device was used in two cases. An assisted 5 mm Trocar was inserted through an incision 2 cm below the left subcostal margin, where a drainage tube was placed after surgery. Results： All the six cases of hybrid tran- sumbilical single port laparoscopic splenectomy were successfully performed. The mean operative time was （ 189.2 ＋ 31.8 ） min （ range 150-225 min）,the mean blood loss was （108.3 -＋ 58.5） ml （range 50-200 ml）, and the post-operative hospital stay was （7.2 -＋ 1.2） d （range 6-9 d）. During the 3-14 months follow-up,the patients recovere well. The umbilical incision was well hidden,the cos- metic result was good. Conclusions：Hybrid transumbilical single port laparoscopic splenectomy is safe, feasible and with better cosmetic results. This procedure is difficult, the indications should be strictly grasped.

关 键 词：脾切除术 腹腔镜检查 单孔 经脐 杂交 

分 类 号：R657.6[医药卫生—外科学]