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盆腔手术中的腹腔镜单孔技术。

Laparoendoscopic single site in pelvic surgery.

作者信息

Sanchez-Salas Rafael, Clavijo Rafael, Barret Eric, Sotelo Rene

机构信息

Institut Montsouris, Paris, France.

出版信息

Indian J Urol. 2012 Jan;28(1):54-9. doi: 10.4103/0970-1591.94958.

Abstract

Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

摘要

经自然腔道内镜手术(LESS)作为一种可行的微创手术技术,近年来发展迅速。我们的目的是描述经自然腔道内镜手术(LESS)在盆腔手术中的现状。我们对LESS盆腔手术的文献进行了全面回顾。通过检索PubMed上从2001年1月1日至2011年11月30日的可用文献,获取了本手稿的参考文献。检索期外的参考文献则从所选手稿的参考文献中获取。检索词包括:盆腔解剖、妇科LESS、单孔结肠切除术、泌尿外科LESS、单孔、单部位、NOTES、LESS和单切口。最初共识别出314篇手稿。其中,基于盆腔解剖或手术内容选择了46篇手稿;包括实验经验、临床系列和文献综述。LESS极大地限制了外科医生在手术视野中的操作能力,而且由于骨盆等解剖部位空间不足,手术视野变得更加受限。认识到手术操作在技术上更具挑战性,LESS的潜在优势才得以体现。与结直肠手术、妇科和泌尿外科相关的盆腔手术已采用LESS技术进行,现有信息大多以病例报告和短篇病例系列呈现。比较性系列研究仍然较少。LESS盆腔手术尚处于起步阶段,鉴于非常特殊的解剖条件,使用机器人技术显然可以促进LESS手术在上述领域的进一步发展。技术的标准化和可重复性对于在手术领域进一步发展LESS至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd64/3339788/dd485ac137d7/IJU-28-54-g001.jpg

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