两镜联合在经脐单孔腹腔镜胆囊切除术的临床应用  

作　　者：宋辰元 王冠羽[2] 

机构地区：[1]天津市新生医院 [2]天津市第一医院

出　　处：《内蒙古中医药》2014年第4期32-33,共2页Inner Mongolia Journal of Traditional Chinese Medicine

摘　　要：目的：探讨两镜联合在经脐单孔腹腔镜胆囊切除术中处理直径大于5mm的胆囊管的操作体会.方法：回顾分析我院33例应用5mm镜头辅助行经脐单孔腹腔镜胆囊切除手术资料,术中利用5mm镜头作为视野镜,普通腔镜的10mm施夹器械通过10mmTroca通道处理直径大于5mm的胆囊管,以改进stryker-康基单孔器械包系统仅有一个10mm Troca通道的缺陷.结果：33例手术均视野良好,器械操作相互无影响,无中转常规腹腔镜手术或开腹手术,平均手术时间43.5分钟（30～ 60分钟）,无胆漏、出血、腹腔包裹性积液和脐疝等并发症发生.结论：应用5mm镜头辅助进行经脐单孔腹腔镜胆囊切除术处理胆囊管直径大于5mm病人安全、可靠,可以改进stryker-康基单孔器械包系统仅有一个10mm Troca通道的缺陷,简化手术操作,值得临床推广.Objective To explore the experience of transumbilieal single incision cholecystectomy under laparoscope combined with hysteroscope in treatment of ductus cysticus greater than 5mm . Methods The clinical data of 33 patients with gallbladder calculi or polyps underwent transom biblical single incision laparoseopic eholecystectomy were retrospectively analyzed. To deal with the limitation of troca chan- nels, a hysteroseope with a diameter of 5ram and a clip applier with 10mm were used in treating atients whose ductus cysticus has dimension greater than 5mm,during the operation. Results No complications occrued intraoperatively or postoperatively. The operation was successfully completed without conversion to routine laparoscopic surgery or open surgery in all of the cases. We achieved a good vision during the opera- tion, By this mean the operation average time was 43.5minutes（ ranged from 30 to 60 minutes）. No complications occrued intraoperatively or postoperatively. Conclusions Combination of hysteroscope and laparoscope in the operation of transumbilical single incision cholecysteetomy for patients whose duetus eysticus has dimension greater than 5 mm is feasible and safe, hysteroseope is use fulin decreasing the difieuhy level of the procedure and dealing with the limitation of troca channels of Kangji medical instruments.

关 键 词：腹腔镜 单孔 胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]