Zhu Jiang Fan, Hu Hai, Ma Ying Zhang, Xu Man Zhu, Li Feng
Department of General Surgery, East Hospital of Tongji University, 150 Ji Mo Road, 200120 Pudong, Shanghai, China.
Surg Endosc. 2009 Apr;23(4):813-7. doi: 10.1007/s00464-008-0086-7. Epub 2008 Jul 23.
There has been great interest in natural orifice transluminal endoscopic surgery (NOTES) in recent years. We report another new approach--transumbilical endoscopic surgery (TUES)--which we have performed in 40 cases for liver cysts (3), bleeding ascites (1), chronic appendicitis (10), and gallbladder diseases (26).
Transumbilical endoscopic liver cyst fenestration, abdominal cavity exploration, appendectomy, and cholecystectomy were performed in a total of 40 patients.
All the operations were completed successfully except one case of intraoperative bleeding in TUES cholecystectomy which was converted to routine laparoscopic surgery. The operating times for TUES cholecystectomy, appendectomy, and liver cyst fenestration were 30-150 min,15-40 min, and 30-90 min, respectively. No postoperative bleeding or bile leakage occurred in this group of patients.
Transumbilical endoscopic surgery is feasible, and would be another option for scarless abdominal surgery. TUES cholecystectomy is technically challenging. Careful selection of patients is important in the initial period of this technique.
近年来，自然腔道内镜手术（NOTES）备受关注。我们报告了另一种新方法——经脐内镜手术（TUES），我们已将其应用于40例患者，治疗肝囊肿（3例）、出血性腹水（1例）、慢性阑尾炎（10例）和胆囊疾病（26例）。
对40例患者实施了经脐内镜肝囊肿开窗术、腹腔探查术、阑尾切除术和胆囊切除术。
除1例TUES胆囊切除术术中出血转为常规腹腔镜手术外，所有手术均成功完成。TUES胆囊切除术、阑尾切除术和肝囊肿开窗术的手术时间分别为30 - 150分钟、15 - 40分钟和30 - 90分钟。该组患者术后无出血或胆漏发生。
经脐内镜手术是可行的，将成为无痕腹部手术的另一种选择。TUES胆囊切除术在技术上具有挑战性。在这项技术的初期，仔细选择患者很重要。
