Liliana Mereu, Alessandro Pontis, Giada Carri, Luca Mencaglia
Department of Gynecology, Centro Oncologico Fiorentino, Sesto Fiorentino, Italy.
J Gynecol Endosc Surg. 2011 Jan;2(1):11-7. doi: 10.4103/0974-1216.85273.
The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach.
基本理念是让所有腹腔镜手术操作端口通过同一个切口进入腹壁。单切口腹腔镜手术是传统多端口腹腔镜手术的一种替代方法。使用经脐端口的单通道腹腔镜手术具有最大的美容优势，因为手术切口隐藏在脐部，降低了微创手术的发病率。单通道腹腔镜手术的优点可能包括出血更少、感染风险更低、疝形成几率更小、美容效果更好以及疼痛更轻。其缺点和局限性包括手术时间更长、技术学习难度大以及需要专用器械。本综述总结了单端口入路腹腔镜子宫切除术（SPAL）的历史，并着重介绍了命名法、手术技术、器械以及围手术期结果。总结了迄今为止单端口子宫切除术在特定妇科应用中的情况。利用PubMed数据库，对过去40年的英文文献进行了回顾。关键词搜索包括无痕、无疤、单端口/套管针/切口、单端口入路腹腔镜子宫切除术。在选定参考文献的参考文献目录中，检索了其他来源。本文的目的是回顾SPAL子宫切除术的发展和现状，并突出与这种创新方法相关的重要进展。
