经脐单一部位腹腔镜精索静脉高位结扎术  

Transumbilical single-site laparoscopic high ligation of spermatic vein for treatment of varicocele

作　　者：张震波[1] 蔡立东[1] 屈栗明[1] 李会宁[1] 

机构地区：[1]陕西省第二人民医院,陕西西安710005

出　　处：《腹腔镜外科杂志》2015年第8期628-630,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨经脐单一部位腹腔镜精索静脉高位结扎术的可行性及临床疗效。方法：回顾分析2009年4月至2015年3月为51例精索静脉曲张患者行经脐单一部位腹腔镜精索静脉高位结扎术的临床资料,其中双侧18例,单侧33例。取脐上缘脐轮处5 mm弧形切口,建立CO2气腹,置入5 mm Trocar,由此置入5 mm腹腔镜,距此5 mm以远两侧脐轮处做5mm弧形切口,置入5 mm Trocar为操作孔。辨认曲张的精索静脉,持电钩于内环口上方2-3 cm处沿血管走向切开腹膜1.5-2.0 cm,直角分离钳游离曲张静脉,普通丝线双道结扎精索静脉。手术均经脐单一部位操作完成,不用钛夹。结果：51例手术均获成功,手术时间单侧10-12 min,双侧13-18 min,术后8-10 h下床活动,3-5 d出院。术后3个月内随访无复发及并发症发生。结论：经脐单一部位腹腔镜精索静脉高位结扎术操作简单,易掌握,腹壁无可见疤痕,具有腹部美容的效果。Objective： To investigate the feasibility and clinical effects of the transumbilical single-site laparoscopic high ligation of spermatic vein for treatment of varicocele. Methods： Retrospective analysis was made on the clinical data of 51 patients with varicocele who underwent transumbilical single-site laparoscopic high ligation of spermatic vein from Apr. 2009 to Mar. 2015,including 18 cases of bilateral ligation and 33 cases of unilateral ligation. A 5 mm curve incision was made in the upper edge of the umbilicus to establish CO2 pneumoperitoneum and a 5 mm Trocar was placed therein,thereby the 5 mm laparoscope entered; and then a 5 mm curve incision was made in each of the two edges of the umbilicus 5 mm distal to that Trocar,and then a 5 mm Trocar was placed respectively therein to serve as operating port. The varicose spermatic vein was recognized,and then electrocantery was used to make a 1. 5-2. 0 cm incision in the peritoneum parallel to the blood vessel at 2-3 cm above the internal ring. The right angle clamp was used to separate varicose spermatic vein,and then the spermatic vein was doubly ligated using common silk thread. The whole process of surgical operation was completed under transumbilical single-port without the use of titanium clip. Results： All operations were completed successfully. The operative time was 10-12 min for unilateral ligation and 13-18 min for bilateral ligation. The patients were able to walk 8-10 h after the operation and were discharged after 3-5 d. Over the follow-up visits of 3 months after operation,there was neither recurrence of varicocele nor occurrence of complications. Conclusions： The transumbilical single-site laparoscopic high ligation of spermatic vein is a feasible procedure,which is easy to grasp and perform,and can achieve the effect of abdominal cosmetic without visible scars at the abdominal wall.

关 键 词：精索静脉曲张 结扎术 腹腔镜检查 经脐 单一部位 

分 类 号：R699.8[医药卫生—泌尿科学]