Takayama Satoru, Nakai Nozomu, Sakamoto Masaki, Takeyama Hiromitsu
Department of Gastroenterological Surgery, Nagoya City University, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan,
Surg Today. 2014 Mar;44(3):513-6. doi: 10.1007/s00595-013-0501-0. Epub 2013 Feb 14.
Single-incision laparoscopic surgery improves the cosmetic outcome after surgery. We herein report six cases of successful single-incision laparoscopic (SILS) herniorrhaphy.
Six patients, five with unilateral inguinal hernias and one with bilateral inguinal hernias, underwent SILS herniorrhaphy. A Covidien SILS port was inserted via an umbilical incision, through which three trocars of 5, 5 and 12 mm (or 5 mm) were inserted. The peritoneum was then opened with flexible scissors and electrocoagulation, after which, the preperitoneal space was dissected. A mesh was then fixed, and the peritoneum was finally closed using Covidien SILS Stitch or AbsorbaTack.
The mean length of the operation for the unilateral cases was 136 min. The increased time was due to difficulties unrelated to this methodology. However, the length of the operation in the bilateral case was 94 min. All patients were discharged without complications.
SILS herniorrhaphy requires experience and more time than conventional three-port herniorrhaphy. However, if the length of the operation can be shortened, then this novel surgical technique is considered to be feasible and it is expected to improve the cosmetic outcome without any additional risk.
单切口腹腔镜手术可改善术后美观效果。我们在此报告6例单切口腹腔镜疝修补术成功病例。
6例患者,5例为单侧腹股沟疝,1例为双侧腹股沟疝,接受了单切口腹腔镜疝修补术。通过脐部切口插入一个柯惠单切口腹腔镜端口,经此端口插入5、5和12毫米(或5毫米)的三个套管针。然后用柔性剪刀和电凝器打开腹膜,之后解剖腹膜前间隙。接着固定补片,最后使用柯惠单切口腹腔镜缝合器或吸收钉闭合腹膜。
单侧病例的平均手术时长为136分钟。时间增加是由于与该方法无关的困难。然而,双侧病例的手术时长为94分钟。所有患者均无并发症出院。
单切口腹腔镜疝修补术比传统三孔疝修补术需要更多经验和时间。然而,如果手术时长能够缩短,那么这种新颖的手术技术被认为是可行的,并且有望在不增加任何额外风险的情况下改善美观效果。