倒C形打结技术在应用标准腹腔镜器械的单孔腹腔镜培训中的应用  

The application of inversion C Knot technique in LESS training under standard laparoscope instrument

作　　者：孟军[1] 张弋[1] 孙国锋[1] 金石华[1] 那彦群[1] 

机构地区：[1]北京大学首钢医院吴阶平泌尿外科医学中心,北京100144

出　　处：《中国内镜杂志》2015年第1期30-33,共4页China Journal of Endoscopy

摘　　要：目的倒C形打结法是我中心首创的腔内打结技术,该文探讨腔内倒C形打结技术在应用标准腹腔镜器械的单孔腹腔镜培训中的有效性及相对其他方法的优越性。方法参加应用标准器械进行单孔腹腔镜打结培训的泌尿外科医师共40人,均为接受过标准腹腔镜打结技术培训并基本掌握标准打结技术("正C线上+反C线上")[1-2],培训前进行问卷调查及GRS评分,然后讲解并指导3种单孔打结方法:抓针法、旋转针持法及倒C形打结法。培训完成后再次评估GRS,并比较3种打结方法在打结时间及GRS评分方面的差异。结果受培训者均能掌握腔内打结方法,培训后GRS评分有显著提高。3种打结方法中倒C形打结法打结平均时间最短,学习曲线最短。结论倒C形打结法是我中心首创的腔内打结技术,本技术具有无需绕线、器械可平行操作、简便易学等特点,即使是初学者也能较快掌握。有效的缩短了单孔腹腔镜下打结的学习曲线,是一种简便有效的值得推广的腔内打结技术,是应用标准腹腔镜器械开展单孔腹腔镜(LESS)手术的钥匙。[ Objective ] Inversion C knot technique is a novel intracorporeal knotting techinque developed by our centre. The aim of this study was to investigate the effectiviness of inversion C knot technique and its superiority over other method in the training of laparoendoscopic single-site surgery （LESS） using the standard laparoscope ap- pliance. [Methods ] 40 urinologist received the training of LESS under standard laparoscope instruments,they were all trained by the standard laparoscope knotting technique（positive c/on suture＋contrary c/on suture） [1] [2]and mastered that technique. Questionnaire survey and Global Rating Scales （GRS） were recorded before the training, then three knot methods were explained and instructed ：taking needle, spin acutenaculum and inversion C knot. Af- ter training, GRS was recorded again and the difference about the GRS and the time used respectively of three methods were compared. [ Results ] All the trainee can master these intracorporeal knotting techniques, the GRS scores were significant higher than before the training. In three methods of knotting, the mean time of inversion C knot is the shortest, its learning curve is the shortest. [ Conclusions ] Inversion C knot technique is developed by our centre. This technique does not need winding suture, can parallel operating, and easily to learn even by a beginner. Obviously, this technique can effectively shorten the learning curve of intracorporeal knotting. It is a simple and ef- fective intracorporeal knotting technique. It is worth of being generalized. It＇s a key of LESS by standard laparoscope appliance.

关 键 词：倒C形打结法 单孔腹腔镜 标准腹腔镜器械 医学继续教育 外科技能培训 

分 类 号：R608[医药卫生—外科学]