单孔腹腔镜技术操作技巧的临床体会

目的:探讨单孔腹腔镜手术的操作技巧。方法:回顾分析2011年1月至2013年1月为189例患者行单孔腹腔镜手术的临床资料。其中单孔腹腔镜胆囊切除术160例、阑尾切除术12例、脾脏切除术7例、切口疝修补术5例、腹股沟斜疝修补术3例、胃癌根治术1例、胰十二指肠切除术1例。结果:本组中1例胆囊切除患者术中胆道损伤,予以放置支架管,一期胆道修复,余均无医源性损伤。术后胆囊切除术患者发生迟发性胆漏1例,经穿刺引流后治愈,余均无发热、腹腔积液发生,患者恢复顺利,痊愈出院。住院4¹5 d。术后随访115 d。术后随访1²3个月,无黄疸、腹部不适等症状。结论:理性的外科操作理念、精准的细节操作、扶镜手与术者的巧妙配合是保证单孔腹腔镜手术顺利进行的关键技巧。

Experience of operation skills in single-port laparoscopic technology 4

Objective：To explore the operative skills of the single-pert laparoscopic surgery. Methods：The clinical data of 189 patients with single port laparoscopic operation from Jan. 2011 to Jan. 2013 were retrospectively analyzed. Single port laparoscopic chole- cystectomy, appendectomy, splenectomy, incisional hernia repair, indirect inguinal hernia repair, radical gastrectomy for gastric cancer and pancreatoduodenectomy was carried out in 160,12,7,5,3,1 and 1 patients respectively. Results：There was one case of biliary inju- ry in one cholecystectomy patient who was treated in one stage repair by stent implantation, and one case of delayed biliary leakage oc- curred in one cholecystectomy patient who was treated by external drainage. The convalescence of the other patients were all uneventful, without any iatrogenic injury, fever, abdominal effusion. The mean hospital stay was 4-15 d. The mean time of follow-up was 1-23 months, there was not any jaundice or abdominal discomfort. Conclusions： The rational surgical concept, precise details during operation and close coordination between assistant and surgeon are key skills of single-port laparoscopic operation.