改良三孔法腹腔镜阑尾切除术的临床体会  

Clinical experience of a modified three-port laparoscopic appendectomy

作　　者：丁建[1] 李海[1] 樊伟[1] 牛虎[1] 李彤[1] 王刚普[1] 

机构地区：[1]济南市第四人民医院,山东济南250031

出　　处：《腹腔镜外科杂志》2013年第9期705-707,共3页Journal of Laparoscopic Surgery

摘　　要：目的:总结改良三孔法腹腔镜阑尾切除术的手术经验与技巧。方法:回顾分析为156例患者行改良三孔法腹腔镜阑尾切除术的临床资料。10 mm观察孔位于脐上缘,第一操作孔(5 mm)位于脐下缘,第二操作孔(5 mm)选在阴毛遮蔽部位,如耻骨联合上缘或左侧耻骨结节上方。紧贴阑尾电凝分离切断阑尾系膜,自制条形取物袋取出阑尾。结果:本组手术均获成功,手术时间平均(60±30)min。4例患者于耻骨联合上切口放置细尿管引流,并于术后3 d内拔除。均无切口感染、出血及肠梗阻等并发症发生。患者均痊愈出院,平均住院(3.5±1.5)d,患者满意度较高。结论:改良三孔法腹腔镜阑尾切除术更美观、实用,术后切口疤痕更隐蔽。Objective：To summarize the operation experience and skill of modified three-port laparoscopic appendectomy. Methods：The clinical data of 156 patients who underwent modified three-port laparoscopic appendectomy were retrospectively ana- lyzed. Observation hole （ 10 mm Trocar） located at upper edge of the navel,and the first operating hole （5 mm Trocar） located at lower edge of the navel,another operation hole （5 mm） was at lower abdomen parts covered by pubic hair such as：the superior border of pu- bic symphysis or above the left pubic tubercle. The mesoappendix was separated and cut off close to appendix using electric coagulation, the appendix was taken out using self-made bar-style bag. Results：The modified three-port laparoseopic appendectomy was sueeessfully performed in all the 156 cases without complications such as ineisional infection, hemorrhage or intestinal obstruction. The mean opera- tive time was （60 ± 30） min. Thin catheter was placed in incision above pubic symphysis for drainage, and was removed 3 d later. Mean hospital stay was （ 3.5 ± 1.5 ） d, all patients were cured and discharged, and satisfied with operative result. Conclusions ： The modified three-port laparoscopic appendectomy is cosmetic, practical and beneficial to the current clinical application, postoperative scar of the incision is well hidden.

关 键 词：阑尾切除术 腹腔镜检查 三孔法 改良 

分 类 号：R656.8[医药卫生—外科学]