Gaur D D, Gopichand M, Dubey M, Jhunjhunwala V
Department of Urology, Bombay Hospital Institute of Medical Sciences, Bombay, India.
J Laparoendosc Adv Surg Tech A. 2002 Oct;12(5):313-5. doi: 10.1089/109264202320884045.
The purpose of this study was to establish the feasibility of primary mini-access to the retroperitoneal space to perform certain retroperitoneoscopic procedures in which an enlarged port is not required for extraction of the specimen. Mini-laparoscopy or needlescopic laparoscopy has been performed in the past via the transperitoneal route, but this has not yet been reported for a retroperitoneoscopic procedure. Through a 5-mm primary access and 3- or 5-mm secondary ports, retroperitoneoscopic surgery was performed in seven adults for ureterolithotomy, renal biopsy, simple nephrectomy, nephropexy, cyst decortication, or drainage of a subphrenic abscess. The access technique used was a mini-version of a previously described percutaneous access technique with some modifications. The retroperitoneoscopic procedure was successful in all seven patients, and no complications developed. The operative time, blood loss, analgesic intake, and length of hospital stay were comparable with those of a standard retroperitoneoscopic procedure. However, the cosmetic results were better. Mini-retroperitoneoscopy is feasible and is a better alternative for patients in whom the whole procedure can be performed through 5-mm or smaller ports.
本研究的目的是确定经皮小切口进入腹膜后间隙以进行某些腹膜后腹腔镜手术的可行性，这些手术不需要扩大切口来取出标本。过去曾通过经腹腔途径进行迷你腹腔镜手术或针式腹腔镜手术，但尚未有关于腹膜后腹腔镜手术的相关报道。通过一个5毫米的主切口和3毫米或5毫米的辅助切口，对7名成年人进行了腹膜后腹腔镜手术，包括输尿管切开取石术、肾活检、单纯肾切除术、肾固定术、囊肿剥除术或膈下脓肿引流术。所采用的进入技术是对先前描述的经皮进入技术的迷你版，并做了一些改进。所有7例患者的腹膜后腹腔镜手术均成功，且未发生并发症。手术时间、失血量、镇痛药物摄入量和住院时间与标准腹膜后腹腔镜手术相当。然而，美容效果更好。迷你腹膜后腹腔镜手术是可行的，对于那些整个手术可以通过5毫米或更小切口完成的患者来说，是一种更好的选择。
