Department of Colorectal Surgery, Beaumont Hospital, Dublin, Ireland.
Colorectal Dis. 2012 Oct;14(10):1267-75. doi: 10.1111/j.1463-1318.2012.02966.x.
Single-access laparoscopic surgery is a recent vogue in the field of minimally invasive colorectal surgery. While selected series have indicated feasibility, we prospectively examined its usefulness for resectional surgery in routine practice.
All patients undergoing laparoscopic colorectal resection over a 12-month period were considered for a single-access approach by a single surgical team in a university hospital. This utilized a 'glove' port via a 3-5 cm periumbilical or stomal site incision, with standard rigid laparoscopic instruments then being used.
Of 76 planned laparoscopic colorectal resections, 35 (47%) were performed by this single-incision laparoscopic modality without disruption of theatre list efficiency or surgical training obligations. The mean (range) age and body mass index of these 25 consecutive right-sided resections, eight total colectomies (seven urgent operations) and two anterior resections was 58 (22-82) years and 23.9 (18.6-36.2) kg/m(2) , respectively. The modal postoperative day of discharge was 4. For right-sided resections, the mean (range) postoperative stay in those undergoing surgery for benign disease was 4.0 days, while for those undergoing operation for neoplasia (n=18, mean age 71 years) it was 5.8 days and the average lymph node harvest was 13. Use of the glove port reduced trocar cost by 58% (€60/£53) by allowing the use of trocar sleeves alone without obturators.
Single-incision laparoscopic surgery is an effective option for abdominal surgery and seems especially suited for laparoscopic-assisted right-sided colonic resections. The glove port technique facilitates procedural frequency and familiarity and proves economically favourable.
单一切口腹腔镜手术是微创结直肠手术领域的最新趋势。虽然一些特定的系列研究表明该方法具有可行性，但我们前瞻性地检查了其在常规实践中用于切除术的实用性。
在一家大学医院，一个外科手术团队对在 12 个月内接受腹腔镜结直肠切除术的所有患者进行了单一切口入路的评估。该方法通过脐部或造口部位 3-5cm 的切口使用“手套”端口，然后使用标准刚性腹腔镜器械。
在 76 例计划进行腹腔镜结直肠切除术的患者中，有 35 例（47%）通过这种单切口腹腔镜方法进行，而不会干扰手术效率或手术培训义务。这 25 例连续右半结肠切除术、8 例全结肠切除术（7 例紧急手术）和 2 例前切除术的患者平均（范围）年龄和体重指数分别为 58（22-82）岁和 23.9（18.6-36.2）kg/m²。术后平均（范围）出院日为 4 天。对于右半结肠切除术，因良性疾病接受手术的患者术后住院时间平均为 4.0 天，而因肿瘤接受手术的患者（n=18，平均年龄 71 岁）为 5.8 天，平均淋巴结清扫数为 13 个。使用手套端口可减少 58%的套管针成本（€60/£53），因为它允许单独使用套管针套而无需使用堵塞器。
单一切口腹腔镜手术是一种有效的腹部手术选择，似乎特别适合腹腔镜辅助右半结肠切除术。手套端口技术有利于手术的频率和熟练度，并且在经济上具有优势。
