Department of Surgery, University Hospital Geneva, 1211, Geneva, Switzerland.
Colorectal Dis. 2010 Jan;12(1):61-5. doi: 10.1111/j.1463-1318.2009.01825.x.
Transumbilical single incision laparoscopic surgery (SILS) has made its initial forays into clinical minimally invasive surgery. SILS combines in part the cosmetic advantage and decrease parietal trauma of natural orifice surgery, but allow operative realization with standard and validated laparoscopic instruments. We report here the first clinical transumbilical SILS sigmoidectomy for benign disease.
Preliminary experience with transumbilical single incision laparoscopic surgery (or embryonic natural orifice transluminal endoscopic surgery) sigmoidectomy in a female patient (34 years, BMI 22 kg/m(2)) with sigmoid stenosis caused by nodular endometriosis was reported. Transumbilical SILS treatment of pelvic endometriosis was performed during the same operation through cauterization.
Transumbilical single incision laparoscopic sigmoidectomy was feasible with conventional laparoscopic instruments. The combined uses of straight and articulated laparoscopic instruments allow the avoidance of transparietal sling suture for exposition. Operative time for sigmoidectomy and endometriosis therapy was 125 min. No intra-operative or postoperative complications were recorded. SILS achieved excellent cosmetic results and may be associated with accelerated recovery.
Transumbilical single incision laparoscopic sigmoidectomy is feasible by experienced laparoscopic surgeons using conventional laparoscopic instruments and staplers. The combined uses of strait and articulated instruments allow transumbilical SILS sigmoidectomy without the need for additional incision or transparietal sling suture. SILS sigmoidectomy may have the clinical advantage over NOTES of offering the safety of laparoscopic colectomy and the avoidance of vaginal access. It has to be determined if SILS offers benefit to the patient, except in cosmesis, compared with standard laparoscopic sigmoidectomy.
经脐单切口腹腔镜手术（SILS）已初步应用于临床微创外科。SILS 部分结合了经自然腔道内镜手术（NOTES）的美容优势和减少壁层创伤，但可使用标准且经过验证的腹腔镜器械来完成手术操作。我们在此报告首例经脐 SILS 乙状结肠切除术治疗良性疾病。
报告了一例 34 岁、BMI 为 22kg/m²的女性患者经脐 SILS 乙状结肠切除术（或胚胎自然腔道经腔内镜手术）的初步经验，该患者因结节性子宫内膜异位症引起乙状结肠狭窄。在同一手术中，通过烧灼对盆腔子宫内膜异位症进行经脐 SILS 治疗。
使用传统腹腔镜器械可进行经脐单切口腹腔镜乙状结肠切除术。直型和弯型腹腔镜器械的联合使用可避免进行壁层提拉缝线暴露。乙状结肠切除术和子宫内膜异位症治疗的手术时间为 125 分钟。未记录到术中或术后并发症。SILS 获得了良好的美容效果，可能与加速康复相关。
有经验的腹腔镜外科医生使用传统腹腔镜器械和吻合器可进行经脐单切口腹腔镜乙状结肠切除术。直型和弯型器械的联合使用可实现无需额外切口或壁层提拉缝线的经脐 SILS 乙状结肠切除术。与NOTES 相比，SILS 可为患者提供腹腔镜结肠切除术的安全性和避免阴道入路，可能具有临床优势。除美容效果外，SILS 与标准腹腔镜乙状结肠切除术相比是否对患者有益，尚需进一步确定。
