Kroh Matthew, Rosenblatt Steven
Department of General Surgery, Surgical Institute, Cleveland Clinic, Cleveland, Ohio, USA.
J Laparoendosc Adv Surg Tech A. 2009 Apr;19(2):215-7. doi: 10.1089/lap.2008.0081.
To report the initial clinical cases of single-port, transumbilical cholecystectomy and inguinal hernia repair using a novel operating device.
One patient each underwent single-port transumbilical cholecystectomy and transabdominal pre-peritoneal (TAPP) inguinal hernia repair using the Uni-X Single Port System (Pnavel Systems, Inc.). The device was placed through a single infraumbilical incision in both cases. Novel, specialized instruments, bowed in the shaft for triangulation, were used in addition to standard laparoscopic instrumentation. During cholecystectomy, a single stab incision was made and a laparoscopic suture passer was used for additional cephalad retraction of the gallbladder.
Both procedures were technically successful without placement of additional trocars. Operative times were 59 and 47 minutes for the cholecystectomy and inguinal hernia, respectively. Blood loss was minimal, and there were no intraoperative complications. The patient who underwent cholecystectomy had a previously placed infusion pump for chronic pain management and was kept overnight. The patient who underwent TAPP hernia repair was discharged the same day. Follow-up at three weeks postoperatively demonstrated the patients to be without complaints.
Transumbilical, single-port cholecystectomy and TAPP inguinal hernia repair are technically feasible. The first initial clinical experience with these procedures using this device is reported.
报告使用一种新型手术装置进行单孔经脐胆囊切除术和腹股沟疝修补术的首例临床病例。
分别有1例患者使用Uni-X单孔系统(Pnavel Systems公司)进行了单孔经脐胆囊切除术和经腹腹膜前(TAPP)腹股沟疝修补术。两例手术均通过脐下单一切口置入该装置。除了标准的腹腔镜器械外,还使用了新型的、杆身弯曲以利于三角操作的专用器械。在胆囊切除术中,做了一个单一切口,并使用腹腔镜缝线推送器进一步向上牵拉胆囊。
两项手术在技术上均获成功,未额外置入套管针。胆囊切除术和腹股沟疝修补术的手术时间分别为59分钟和47分钟。出血量极少,术中无并发症。接受胆囊切除术的患者之前放置了用于慢性疼痛管理的输液泵,并留院过夜。接受TAPP疝修补术的患者于同日出院。术后三周的随访显示患者无不适主诉。
经脐单孔胆囊切除术和TAPP腹股沟疝修补术在技术上是可行的。本文报告了使用该装置进行这些手术的首例临床经验。