论著-头颈部
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
作者:陈梦捷1 曾 飚1 陈继明2
所属单位: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)
PDF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
【中图分类号】R61
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2019.02.023
前言
经脐单孔腔镜手术近几年逐渐成为妇科微创手术 研究新热点,目前国外已有关于经脐单孔腔镜实施输 卵管、附件良性肿物手术及全子宫切除术等相关文献 报道,国内也有经脐单孔腔镜治疗妇科良性疾病的 相关文献[1-5]。我院在暂未引进单孔腔镜多通道套管 (Tri-port)设备以及专用手术器械的情况下,采用单 孔三通道穿刺法,模拟Tri-port设备的工作通道,联 合传统腹腔镜手术器械,顺利完成4例单孔腔镜下的 附件手术,均取得了良好的临床效果,现报道如下。
罕少疾病杂志
第26卷, 第 2 期
2019年03月
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