Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, Japan.
Surg Today. 2012 Jun;42(6):601-4. doi: 10.1007/s00595-012-0120-1. Epub 2012 Jan 26.
Single-incision laparoscopic fundoplication for gastroesophageal reflux disease is not widespread because of its technical difficulty. On the other hand, patients with gastroesophageal reflux frequently also have mental retardation and eating disorders. We have been performing single-incision laparoscopic fundoplication via a gastrostomy site incision since October 2009 for these patients. The treated patients were 4 males and 1 female. A small skin incision was made on the gastrostomy site and a SILS port was placed. Under pneumoperitoneum, a single-incision laparoscopic Nissen fundoplication and gastrostomy were performed with a flexible scope, conventional instruments, and high-dexterity instruments. The pneumoperitoneal time was 115-180 min and blood loss was 1-15 ml. There were no intra- or postoperative complications. The hospital stay was under 8 days for all patients. Using this procedure, the incidence of postoperative intestinal obstruction was very low. The results indicate this procedure can be used as a standard operation for these patients in the future.
由于技术难度大，单切口腹腔镜胃底折叠术治疗胃食管反流病尚未广泛开展。另一方面，胃食管反流病患者常伴有智力障碍和饮食失调。自 2009 年 10 月以来，我们一直采用经胃造口部位小切口行单切口腹腔镜胃底折叠术治疗这些患者。治疗的患者为 4 男 1 女。在胃造口部位做一个小皮肤切口，放入 SILS 端口。在气腹下，用软镜、常规器械和高灵巧性器械行单切口腹腔镜 Nissen 胃底折叠术和胃造口术。气腹时间为 115-180 分钟，出血量为 1-15ml。无术中或术后并发症。所有患者的住院时间均在 8 天以内。使用该方法，术后肠梗阻的发生率非常低。结果表明，该方法可作为今后治疗这些患者的标准手术。
