Tung Vicrumdeep S, Buchberg Brian, Masoomi Hossein, Reavis Kevin, Nguyen Ninh T, Mills Steven, Stamos Michael J
University of California-Irvine Medical Center, Orange, CA, USA.
Surg Innov. 2011 Mar;18(1):79-85. doi: 10.1177/1553350610387801. Epub 2010 Dec 27.
Minimally invasive surgery continues to revolutionize surgical standards with trends toward further minimalization and improved cosmesis. Approaches such as laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery (NOTES) have thus emerged. The authors devised an alternative method for a more efficient approach to minimally invasive surgery called no visible scar (NVIS). This study describes NVIS and its ability to provide operative capacity and outcomes similar to other minimal access techniques, but with improved cosmesis and possibly decreased associated complications.
This is a retrospective analysis of patients undergoing colectomy between June 2009 and March 2010 to evaluate our outcomes with the NVIS technique (surgical approach via a 4-5 cm suprapubic site for inserting trocars/multiport and specimen extraction, with a 5-mm umbilical incision for a single trocar). Outcome measures included intraoperative complications, postoperative morbidity, and cosmetic outcome.
Ten patients with a mean age of 60.3 years underwent NVIS colectomy. The average operating time was 161.3 minutes with a mean blood loss of 56.5 mL. There were no conversions to open surgery. One patient required additional trocar placement. No perioperative complications were encountered. On follow-up, no wound complications were noted and all patients appeared satisfied with their cosmetic outcome. One patient was readmitted for a low-grade fever, but the NVIS technique was not identified as a contributor.
NVIS is a safe and feasible minimal access alternative, which improves cosmesis and may decrease complications associated with other minimally invasive techniques. Further analysis in a larger patient population is warranted to support our findings.
微创手术持续变革手术标准，呈现出进一步微创化和改善美容效果的趋势。诸如腹腔镜单孔手术（LESS）和经自然腔道内镜手术（NOTES）等术式因此应运而生。作者设计了一种名为无痕手术（NVIS）的替代方法，以更高效地实施微创手术。本研究描述了NVIS及其提供与其他微创技术相似的手术能力和结果的能力，但具有更好的美容效果且可能减少相关并发症。
这是一项对2009年6月至2010年3月期间接受结肠切除术患者的回顾性分析，以评估我们采用NVIS技术（经耻骨上4 - 5厘米部位插入套管针/多端口及取出标本的手术入路，单套管针通过5毫米脐部切口）的手术结果。结果指标包括术中并发症、术后发病率和美容效果。
10例平均年龄为60.3岁的患者接受了NVIS结肠切除术。平均手术时间为161.3分钟，平均失血量为56.5毫升。无中转开腹手术情况。1例患者需要额外放置套管针。未发生围手术期并发症。随访时，未发现伤口并发症，所有患者对其美容效果均表示满意。1例患者因低热再次入院，但未确定NVIS技术与之有关。
NVIS是一种安全可行的微创替代方法，可改善美容效果，并可能减少与其他微创技术相关的并发症。有必要在更大规模的患者群体中进行进一步分析以支持我们的研究结果。
