使用针形套圈牵开器进行的迷你腹腔镜阑尾切除术可提供最佳的美容效果。
Mini-laparoscopic appendectomy using a needle loop retractor offers optimal cosmetic results.
作者信息
Sato N, Kojika M, Yaegashi Y, Suzuki Y, Kitamura M, Endo S, Saito K
机构信息
Department of Critical Care Medicine, Iwate Medical University, School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan.
出版信息
Surg Endosc. 2004 Nov;18(11):1578-81. doi: 10.1007/s00464-003-8248-0. Epub 2004 Sep 23.
BACKGROUND
Do conventional laparoscopic appendectomy (LA) techniques provide truly satisfying results for patients and surgeons? We have devised a more advanced technique that improves cosmesis.
METHODS
A 2-mm scope is inserted at the umbilicus, and a 12-mm working trocar is inserted through a suprapubic incision placed below the line of pubic hair. A needle loop retractor (NLR) is inserted to hold the appendix in the lower right abdomen. In this NLR, a stainless steel wire is placed within a needle having a diameter of 2 mm. From the suprapubic trocar, a bipolar coagulator is inserted to transect the appendiceal mesentery. A series of 30 patients underwent this procedure.
RESULTS
There were no conversions to laparotomy and no intra- or postoperative complications.
CONCLUSIONS
Laparoscopic appendectomy using a 2-mm scope, suprapubic trocar, and an NLR yields optimal cosmetic results. For surgeons, the NLR allows the appendix to be held more firmly than then a 5- or 2-mm grasping forceps is used.
背景
传统的腹腔镜阑尾切除术（LA）技术能否为患者和外科医生提供真正令人满意的结果？我们设计了一种更先进的技术，可改善美容效果。
方法
在脐部插入一个2毫米的腹腔镜，通过阴毛线下方的耻骨上切口插入一个12毫米的操作套管针。插入一个针环牵开器（NLR）以将阑尾固定在右下腹部。在这个NLR中，一根不锈钢丝放置在直径为2毫米的针内。从耻骨上套管针插入双极电凝器以横断阑尾系膜。30例患者接受了该手术。
结果
无中转开腹病例，无术中或术后并发症。
结论
使用2毫米腹腔镜、耻骨上套管针和NLR进行腹腔镜阑尾切除术可产生最佳的美容效果。对于外科医生来说，与使用5毫米或2毫米抓钳相比，NLR能更牢固地固定阑尾。
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