Ohl F, Popken G
Klinik für Urologie, Helios-Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125 Berlin, Deutschland.
Urologe A. 2010 Nov;49(11):1372-6. doi: 10.1007/s00120-010-2365-x.
Single-port surgery (LESS) is a new method of minimally invasive laparoscopic urology. These modern methods reduce the tissue trauma of the patient; however, high demands are placed on the surgeon. We report our initial clinical experience.
Eight patients with different pathologies in the abdomen and retroperitoneum (nephrectomy, renal cyst resection) were treated with an abdominal LESS access and two patients with vaginal NOS (natural orifice surgery) access. Previously, we obtained extensive experience with the setup and implementation in animal studies. The port placements were realized by various single-port systems in the paraumbilical region.
All procedures were performed without conversion to an open surgical procedure. Two additional trocars were needed in the first single-port operation. The intra- and postoperative follow-up was uneventful in all patients. The average age of the patients was 58.9 years, the average operating time 131 min, the mean blood loss 70 ml, and the median body mass index 27. The postoperative evaluation of patient satisfaction revealed that all patients were perfectly satisfied.
With appropriate experience and training of the whole team, single-port surgery is a safe and appropriate method for selected renal surgery.
单孔手术(LESS)是微创腹腔镜泌尿外科的一种新方法。这些现代方法减少了患者的组织创伤;然而,对外科医生的要求很高。我们报告我们的初步临床经验。
8例腹部和腹膜后不同病变(肾切除术、肾囊肿切除术)的患者采用腹部LESS入路治疗,2例患者采用阴道自然腔道手术入路。此前,我们在动物研究的设置和实施方面获得了丰富经验。通过各种单孔系统在脐旁区域实现端口放置。
所有手术均未转为开放手术。在第一例单孔手术中需要额外使用两个套管针。所有患者的术中和术后随访均顺利。患者的平均年龄为58.9岁,平均手术时间为131分钟,平均失血量为70毫升,中位体重指数为27。患者满意度的术后评估显示所有患者都非常满意。
通过整个团队的适当经验和培训,单孔手术是一种适用于特定肾脏手术的安全且合适的方法。