Ceci F, Di Grazia C, Cipriani B, Nicodemi S, Corelli S, Pecchia M, Martellucci A, Costantino A, Stefanelli F, Salvadori C, Napoleoni A, Parisella M, Spaziani E, Stagnitti F
Department of General and Emergency Surgery, Sapienza University of Rome, Rome, Italy.
G Chir. 2012 Aug-Sep;33(8-9):280-4.
Single Incision Laparoscopic Surgery (SILS) is a recent surgical technique, first described in the 1990s. Its aim is to optimize the esthetic result offered by laparoscopy by minimizing the number of abdominal incisions. Various preliminary studies have been carried out on the application of SILS, especially in cholecystectomy and appendectomy. This study evaluates the preliminary results of cholecystectomy by SILS (SILS™ Port) conducted between October 2009 and February 2011 on 21 patients (4 men and 17 women) with a mean age of 49.9 years and a mean Body Mass Index (BMI) of 22.8. All patients were treated by the same team, which had previously undergone six months' simulator training. There were two main selection criteria, both evaluated intraoperatively: absence of adhesions and of significant inflammatory sequelae from previous cholecystitis; and suitable distance between gallbladder and SILS access port. Conversion to traditional laparoscopy was necessary in just two cases, while an accessory trocar was introduced in another two cases. Conversion to open surgery was not necessary in any case. One case of SILS cholecystectomy was complicated by postoperative bile leakage, which was treated conservatively, as the fistula had a low output. The mean duration of hospitalization was 3.6 days. This preliminary experience led us to conclude that SILS is safe and highly satisfactory in the postoperative phase, thanks to the reduced need for painkillers and the improved esthetic result.
单孔腹腔镜手术（SILS）是一种近期出现的外科技术，于20世纪90年代首次被描述。其目的是通过减少腹部切口数量来优化腹腔镜手术的美观效果。关于SILS的应用已经开展了各种初步研究，尤其是在胆囊切除术和阑尾切除术中。本研究评估了2009年10月至2011年2月期间对21例患者（4例男性和17例女性）实施的单孔腹腔镜胆囊切除术（SILS™端口）的初步结果，这些患者的平均年龄为49.9岁，平均体重指数（BMI）为22.8。所有患者均由同一团队治疗，该团队此前已接受了六个月的模拟器训练。有两个主要的选择标准，均在术中进行评估：无粘连且无既往胆囊炎的明显炎症后遗症；胆囊与SILS接入端口之间的距离合适。仅2例需要转为传统腹腔镜手术，另外2例引入了辅助套管针。在任何情况下都无需转为开放手术。1例单孔腹腔镜胆囊切除术患者术后出现胆漏，由于瘘管引流量少，采取了保守治疗。平均住院时间为3.6天。这一初步经验使我们得出结论，单孔腹腔镜手术在术后阶段是安全且非常令人满意的，这得益于对止痛药需求的减少和美观效果的改善。
