Tsujie Masanori, Ikenaga Masakazu, Miyamoto Atsushi, Nakamori Shoji, Yasui Masayoshi, Omiya Hideyasa, Hirao Motohiro, Takami Koji, Fujitan Kazumasa, Mishima Hideyuki, Tsujinaka Toshimasa
Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Hepatogastroenterology. 2012 Nov-Dec;59(120):2407-9. doi: 10.5754/hge12111.
BACKGROUND/AIMS: Single incision laparoscopic cholecystectomy (SILC) has two serious problems; its feasibility and cost. We report our experience and benefits of our original SILC procedure using homemade trocars that can solve those problems.
SILC was attempted for thirty-four patients at our hospital. The SILST" Port (Covidien, Inc) was used in 16 patients (SPgroup) and the original method using a surgical glove port with homemade trocars was performed in 18 patients (GP-HT group). A homemade trocar was made ofa 2.5mL and a 5mL syringe. We performed the retrospective comparison of the operative and postoperative results between those two groups.
Thirty patients (14 in the SP group and 16 in the GP-HT group)successfully underwent SILC. No patient had a grade IIor more severe postoperative complication based on the Clavien-Dindo classification. Our original home made trocar was slim and compact enough to avoid clashes among surgical instruments and surgeon's hands. Operative time in the GP-HT group was significantly short-er than that in the SP group (p=0.0044).
Although further prospective studies of larger series should be performed, this simple and cost-effective system can be one of the promising ways for SILC.
背景/目的:单孔腹腔镜胆囊切除术(SILC)存在两个严重问题,即可行性和成本。我们报告了使用自制套管针进行的原创SILC手术的经验和优势,该方法可解决上述问题。
我院对34例患者尝试进行SILC。16例患者使用SILST™ Port(柯惠医疗公司)(SP组),18例患者采用使用带有自制套管针的手术手套端口的原创方法(GP-HT组)。自制套管针由一个2.5mL和一个5mL注射器制成。我们对两组患者的手术及术后结果进行了回顾性比较。
30例患者(SP组14例,GP-HT组16例)成功接受了SILC。根据Clavien-Dindo分类,无患者出现II级或更严重的术后并发症。我们原创的自制套管针纤细且紧凑,足以避免手术器械与术者手部之间的碰撞。GP-HT组的手术时间明显短于SP组(p = 0.0044)。
尽管应开展更大样本量的进一步前瞻性研究,但这种简单且经济高效的系统可能是SILC的一种有前景的方法。