Carr Aaron, Bhavaraju Avinash, Goza John, Wilson Russell
Atlanta Medical Center and Piedmont Fayette Department of General Surgery, Atlanta, Georgia, USA.
Am Surg. 2010 Jul;76(7):703-7.
Single-incision laparoscopic surgical procedures are being developed with the goal of improving cosmesis, reducing postoperative pain, and increasing patient satisfaction. We performed this study to evaluate our initial experience with single-incision laparoscopic cholecystectomy. We used an infraumbilical incision with two upper low-profile 5-mm ports and one lower standard 5-mm port and either a standard 30 degrees Storz laparoscope or an Olympus deflectable tip laparoscope. All patients were followed postoperatively to evaluate the feasibility and outcomes of the procedure. A total of 60 gallbladders were successfully removed by this method (95.2% success rate). Three cases were converted to standard laparoscopic cholecystectomy (4.8% conversion rate) with no conversion to open cholecystectomy. There were no major complications (bile duct injury, liver injury, bowel injury, biliary leak). Median operative time was 51 +/- 21 minutes. Diagnoses included cholelithiasis (55%), biliary dyskinesia (32%), biliary colic (13%), and one case of gangrenous cholecystitis. Median patient age was 47 years with a strong female predominance (87%). Our initial experience demonstrates that single-incision laparoscopic cholecystectomy is effective and safe. We are confident that single-incision laparoscopic cholecystectomy is a viable alternative to standard laparoscopic cholecystectomy.
单切口腹腔镜手术正在发展，目标是改善美观、减轻术后疼痛并提高患者满意度。我们开展这项研究以评估我们单切口腹腔镜胆囊切除术的初步经验。我们采用脐下切口，配备两个上侧的 5 毫米低轮廓端口和一个下侧的标准 5 毫米端口，使用标准的 30 度史托斯腹腔镜或奥林巴斯可弯式尖端腹腔镜。所有患者术后均接受随访，以评估该手术的可行性和结果。通过该方法共成功切除 60 个胆囊（成功率为 95.2%）。3 例转为标准腹腔镜胆囊切除术（转化率为 4.8%），无转为开腹胆囊切除术的情况。无重大并发症（胆管损伤、肝损伤、肠损伤、胆漏）。中位手术时间为 51±21 分钟。诊断包括胆结石（55%）、胆囊运动障碍（32%）、胆绞痛（13%）以及 1 例坏疽性胆囊炎。患者中位年龄为 47 岁，女性占主导（87%）。我们的初步经验表明单切口腹腔镜胆囊切除术有效且安全。我们相信单切口腹腔镜胆囊切除术是标准腹腔镜胆囊切除术的可行替代方案。
