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腹腔镜单部位经膀胱输尿管再植术治疗成人膀胱输尿管反流:一年随访。

Laparoendoscopic single-site transvesical ureteroneocystostomy for vesicoureteral reflux in an adult: a one-year follow-up.

机构信息

Department of Urology, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Urology. 2012 Sep;80(3):719-23. doi: 10.1016/j.urology.2012.06.028.

Abstract

INTRODUCTION

Various minimally invasive techniques have been developed to decrease morbidity related to laparoscopic port placement and to improve cosmetic results while maintaining the same standards and efficacy of surgical care. One such approach is laparoendoscopic single-site surgery. We describe our initial clinical experience of using this technique for transvesical ureteral reimplantation.

TECHNICAL CONSIDERATIONS

The procedure was performed transvesically (percutaneous intraluminal approach) with a single-port device (3-channel) via a 1.5-cm incision made 2 cm above the pubic symphysis. A standard 10-mm laparoscope was used with either straight or articulating instruments. The ureter was dissected, shortened, passed through the submucosal tunnel, and fixed in place with a running absorbable V-Loc suture. The operative time was 250 minutes. No significant bleeding or other complications were observed.

CONCLUSION

Although further development of the instruments and skills is needed laparoendoscopic single-site surgery transvesical reimplantation of the ureter appeared to be feasible and safe. Nevertheless, further experience and observations are necessary.

摘要

介绍

为了降低腹腔镜套管放置相关的发病率并改善美容效果,同时保持手术护理的相同标准和疗效,已经开发了各种微创技术。其中一种方法是经腹腔镜单部位手术。我们描述了我们使用该技术进行经膀胱输尿管再植术的初步临床经验。

技术考虑因素

该手术经膀胱(经皮腔内途径)进行,使用单端口装置(3 通道),在耻骨联合上方 2cm 处做 1.5cm 切口。使用标准的 10mm 腹腔镜和直型或关节型器械。输尿管切开、缩短、穿过黏膜下隧道,并使用可吸收的 V-Loc 缝线连续固定。手术时间为 250 分钟。未观察到明显出血或其他并发症。

结论

尽管需要进一步开发器械和技能,但经腹腔镜单部位手术经膀胱输尿管再植术似乎是可行和安全的。然而,还需要进一步的经验和观察。

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