单孔三通道法联合传统腹腔镜器械行单孔腔镜下附件手术初探  

Three-channel Single Port Laparoendoscopic Single-site Surgery(LESS) in Adnexal Surgery

作　　者：陈梦捷 曾飚[1] 陈继明 CHEN Meng-jie;ZENG Biao;CHEN Ji-ming(Department of Obstetrics and Gynecology,Second Affiliated Hospital of Chongqing Medical University,Chongqing400010,China)

机构地区：[1]重庆医科大学附属第二医院妇产科,重庆400010 [2]南京医科大学附属常州第二人民医院妇产科,江苏常州213000

出　　处：《罕少疾病杂志》2019年第2期56-58,71,F0002,共5页Journal of Rare and Uncommon Diseases

摘　　要：目的初步探讨采用单孔三通道法联合传统腹腔镜手术器械行单孔腔镜下附件手术的可行性与安全性。方法回顾分析2017年10月～2017年12月重庆医科大学附属第二医院妇科采用单孔三通道法联合传统腹腔镜手术器械行单孔腔镜下附件手术的4例患者的临床资料。均经脐孔上缘行半环形切口长约2.0cm,采用单孔三通道法进行穿刺,置入传统腹腔镜及手术器械实施手术。结果 4例手术均获得成功,术中未增加其它穿刺通道,均未中转开腹,患者术后均无发热,术后4～5d出院,均无感染、脐疝、出血及伤口愈合不良等并发症发生。结论①针对具有实施传统腹腔镜附件手术能力的医疗单位,选择合适的病例,采用单孔三通道法联合传统腔镜器械行单孔腔镜附件手术是一种安全可行、微创且美容的手术方式;②盆腔子宫内膜异位症、卵巢子宫内膜异位囊肿的治疗也可采用此手术方式,但手术难度相应增大。Objective We present our initial experience with laparoendoscopic single-site surgery(LESS)by three-channel single port through a trans-umbilical access for adnexal tumors and report on the safety and feasibility of this technique.Methods A retrospective analysis was performed of 4 patients from October 2017 to December 2017 who underwent adnexal surgeries through LESS procedure by three-channel single port combined with the conventional laparoscopic instruments.LESS was performed by using a single port with triple-channel inserted method through a solitary 2.0 cm upper umbilicus incision and conventional laparoscopic instruments.Results All of the 4 patients had LESS surgeries successfully.No additional trocar required,no conversion to laparotomy happened.The operation incision scars of the 4 patients all healed well and were not obvious.The patients were discharged within 4-5 days after procedure without complications such as post-operative fever,umbilical hernia,hemorrhage or infection.Conclusion(1)With the strict precondition of indication,LESS using single port with triple-channel inserted method and conventional laparoscopic instruments can be a promisingly safe,minimally invasive and cosmetic approach to adnexal surgery.(2)Such technique can be used in therapy for pelvic endometriosis or ovarian endometriosis cyst,which may be more difficult.

关 键 词：单孔三通道法 单孔腔镜手术 经脐 附件手术 盆腔子宫内膜异位症 

分 类 号：R61[医药卫生—外科学]