Kravetz Amanda J, Iddings Douglas, Basson Marc D, Kia Michael A
Department of Surgery, Michigan State University College of Human Medicine, Lansing, USA.
JSLS. 2009 Jul-Sep;13(3):332-6.
Single-port surgery is a rapidly advancing technique in laparoscopic surgery. Currently, there is limited evidence on the learning curve and practicality of performing single-port laparoscopic cholecystectomy.
Single-port cholecystectomy was performed on 20 consecutive patients for biliary dyskinesia, symptomatic cholelithiasis, or acute cholecystitis. The Tri-Port was placed in the umbilicus, and a combination of straight and articulating instruments were utilized. Patient characteristics and outcomes were reviewed, and a comparison was made with the prior 20 consecutive laparoscopic cholecystectomies performed using the 3-port technique.
Characteristics were similar in both groups. The 3-port cholecystectomy had a mean time of 65.7 minutes, and patients had an average body mass index of 28.16. The first single-port cholecystectomy took 160 minutes with sequential improvement to the sixth case of 66 minutes with a mean of 68.2 minutes for the last 15 single-port cases. The average patient body mass index was 30.24. No major complications occurred.
The largest series to date of single-port cholecystectomy for multiple degrees of biliary disease is presented. This study validates that this technique can be applied effectively and performed in comparable operative times to traditional 3-port cholecystectomy with a learning curve of approximately 5 cases.
单孔手术是腹腔镜手术中一项迅速发展的技术。目前，关于单孔腹腔镜胆囊切除术的学习曲线和实用性的证据有限。
对20例因胆囊运动障碍、有症状的胆结石或急性胆囊炎的患者连续进行单孔胆囊切除术。将三通道端口置于脐部，并使用直形和关节式器械相结合的方式。回顾患者的特征和手术结果，并与之前连续20例使用三孔技术进行的腹腔镜胆囊切除术进行比较。
两组患者的特征相似。三孔胆囊切除术的平均时间为65.7分钟，患者的平均体重指数为28.16。第一例单孔胆囊切除术用时160分钟，随后逐渐缩短，至第六例用时66分钟，最后15例单孔手术的平均用时为68.2分钟。患者的平均体重指数为30.24。未发生重大并发症。
本文报道了迄今为止针对多种胆道疾病进行单孔胆囊切除术的最大病例系列。本研究证实，该技术可有效应用，手术时间与传统三孔胆囊切除术相当，学习曲线约为5例。
