Vidal Oscar, Valentini Mauro, Espert Juan J, Ginesta Cesar, Jimeno Jaime, Martinez Alberto, Benarroch Guerson, Garcia-Valdecasas Juan C
Department of General Surgery, Hospital Clinic i Provincial de Barcelona Villarroel 170, Escalera 9-4 Planta Barcelona, 08036 Spain.
J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):599-602. doi: 10.1089/lap.2009.0205.
Laparoscopic cholecystectomy via the three-trocar technique is widely used for symptomatic gallbladder stones. In this article, we describe the initial experience with laparoendoscopic single-site surgery (LESS) cholecystectomy.
Between February and April 2009, patients referred for cholecystectomy to the General Surgery Unit of our institution who agreed to undergo LESS were included in a prospective study. All operations were performed by the same surgical team that was specially trained in this type of surgery. The umbilicus was the sole point of entry for all patients. The same operative technique was used in all patients. Data of patients undergoing LESS cholecystectomy were compared with those from an uncontrolled group of patients undergoing standard laparoscopic cholecystectomy during the same study period.
The LESS and standard cholecystectomy groups included 19 patients each. LESS was successfully performed in all patients and none required conversion to an open procedure or a conventional laparoscopic cholecystectomy by adding more entry ports. The median operating time of 62 minutes in the LESS group was not significantly different than that in the standard laparoscopic cholecystectomy group.
LESS cholecystectomy was technically feasible, safe, and represents a reproducible alternative to standard laparoscopic cholecystectomy.
经三孔技术的腹腔镜胆囊切除术广泛应用于有症状的胆囊结石。在本文中，我们描述了经自然腔道内镜手术（LESS）胆囊切除术的初步经验。
2009年2月至4月期间，我院普通外科收治的同意接受LESS的胆囊切除术患者被纳入一项前瞻性研究。所有手术均由经过此类手术专门培训的同一手术团队进行。脐部是所有患者的唯一入路点。所有患者均采用相同的手术技术。将接受LESS胆囊切除术患者的数据与同一研究期间接受标准腹腔镜胆囊切除术的非对照患者组的数据进行比较。
LESS组和标准胆囊切除术组各有19例患者。所有患者LESS手术均成功完成，无一例需要通过增加更多入路端口转为开放手术或传统腹腔镜胆囊切除术。LESS组的中位手术时间为62分钟，与标准腹腔镜胆囊切除术组无显著差异。
LESS胆囊切除术在技术上可行、安全，是标准腹腔镜胆囊切除术的一种可重复的替代方法。
