Kim Woo-Chul, Im Kyoung-Shil, Kwon Yong-Soon
Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
JSLS. 2011 Apr-Jun;15(2):222-7. doi: 10.4293/108680811X13071180406510.
To evaluate the efficiency and feasibility of single-port access transumbilical laparoscopic-assisted surgery in patients with large (>8cm) adnexal tumors and to present our initial experience.
Twenty-two patients with presumably benign adnexal tumors who have undergone single-port access transumbilical laparoscopic-assisted surgery were enrolled. The procedure was performed using the method of exteriorization and extracorporeal surgery of adnexal tumors outside the abdominal cavity under laparoscopic guidance with preservation of as much ovarian tissue as possible. In each case, a homemade single-port device was inserted into the abdomen through a 2-cm umbilical incision. The clinical characteristics and operative outcomes of these patients were reviewed.
Twenty of 22 cases were completed successfully. The one failed case required an additional trocar for adequate adhesiolysis, and the other case needed intraperitoneal drainage. The median operating time was 50 minutes (range, 35 to 120), and the estimated blood loss was 38mL (range, 10 to 300). Cyst rupture occurred in 2 cases, but there were no major postoperative complications.
Single-port access transumbilical laparoscopic-assisted surgery for benign and relatively large adnexal tumors is feasible and could be an alternative to convention open laparotomy or laparoscopic surgery.
评估单孔入路经脐腹腔镜辅助手术治疗大型(>8cm)附件肿瘤患者的有效性和可行性,并介绍我们的初步经验。
纳入22例疑似良性附件肿瘤且接受单孔入路经脐腹腔镜辅助手术的患者。该手术采用在腹腔镜引导下将附件肿瘤在腹腔外进行外置化及体外手术的方法,尽可能保留卵巢组织。每例均通过一个2cm的脐部切口将自制单孔装置置入腹腔。回顾这些患者的临床特征及手术结果。
22例中有20例成功完成手术。1例失败病例需要额外的套管针以充分松解粘连,另1例需要腹腔引流。中位手术时间为50分钟(范围35至120分钟),估计失血量为38mL(范围10至300mL)。2例发生囊肿破裂,但无重大术后并发症。
单孔入路经脐腹腔镜辅助手术治疗良性且相对较大的附件肿瘤是可行的,可作为传统开腹手术或腹腔镜手术的替代方法。