可弯曲器械经脐单一部位腹腔镜胆囊切除术65例体会  

Transumbilical Laparoendoscopic Single-site Cholecystectomy Using Flectional Instruments: Report of 65 Cases

作　　者：秦建伟[1] 高静涛[1] 王建国[1] 徐琦[1] 李智平[1] 蒋立钊 刘石[1] 

机构地区：[1]解放军第一医院肝胆外科,兰州730030

出　　处：《中国微创外科杂志》2013年第8期695-696,704,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的总结使用可弯曲腹腔镜器械行经脐单一部位腹腔镜胆囊切除术的体会。方法 2012年1～10月,对58例胆囊结石和7例胆囊息肉样病变施行经脐单一部位腹腔镜胆囊切除术。经脐上缘2.5 cm弧形切口放置10、5、5 mm 3枚trocar,置入30°腹腔镜、可弯曲抓钳和可弯曲电钩,Hem-o-lok夹闭胆囊管及胆囊动脉。结果 61例(93.8%)经脐完成手术,4例转为三孔法。手术时间34～110 min,平均52.4 min;出血量10～150 ml,平均38.4 ml。术后均无出血、胆漏、脐疝、切口感染等并发症。住院时间4～6 d,平均4.8 d。术后随访2周～3个月,腹壁瘢痕小,且隐藏于脐内不明显。结论使用可弯曲腹腔镜器械行经脐单一部位腹腔镜胆囊切除术安全可行,术后切口美容效果好。Objective To evaluate the method and effect of laparoendoscopic single-site surgery （LESS） in the treatment of cholecystectomy by using flectional laparoscopic instruments. Methods From January 2012 to October 2012, 58 patients with cholecytolithiasis and 7 patients with eholecyst polyp underwent transumbilical laparoendoscopic single-site cholecystectomy. A 2.5 cm supra-umbilical curved incision was made followed by the placement of 3 trocars（ 10,5,5 mm）. A 30-degree laparoseope was inserted. Flectional graspers and flectional hook eleetrocautery device were used in performing the operations. The cystic duct and cystic artery was clipped with Hem-o-lok. Results 61 operations （93.8%） were performed successfully with flectional laparoscopic instruments without drainage and the other 4 cases were converted to three ports technique. Operation time was 34 to 110 rain （mean, 52.4 rain） ; blood loss was 10 to 150 ml （mean, 38.4 ml）. No postoperative bleeding, bile leakage, umbilical hernia and incision infection occurred. The hospital stay was 4 to 6 days （ average 4.8 d）. No surgical sear could be obviously observed during the 2-week to 3-month follow-up. Conclusion The application of flectional instruments in transumbilieal laparoendoscopic single-site cholecystectomy is safe and feasible with cosmetic incision.

关 键 词：胆囊切除术 单一部位腹腔镜手术 

分 类 号：R657.4[医药卫生—外科学]