Javed Amit, Agarwal Anil K
Department of GI Surgery, GB Pant Hospital & MAM College, New Delhi, India.
J Minim Access Surg. 2013 Jan;9(1):42-4. doi: 10.4103/0972-9941.107142.
Trichobezoar which were traditionally managed by open surgical retrieval are now often managed by minimally invasive surgical approach. Removal of a large trichobezoar by laparoscopy, however, needs an incision (usually 4-5 cm in size) for specimen removal and has the risk of intra-peritoneal spillage of hair and inspissated secretions.
The present paper describes a modified laparoscopy-assisted technique with temporary gastrocutaneopexy for the effective removal of a large trichobezoar using a camera port and a 4-5 cm incision (which is similar to that needed for specimen removal during laparoscopy).
Three patients with large trichobezoar were managed with the described technique. The average duration of surgery was 45 (30-60) min and the intraoperative blood loss was minimal. There was no peritoneal spillage and the trichobezoar could be retrieved through a 4-5 cm incision in all patients. All had an uneventful recovery and at a median followup of 6 months had excellent cosmetic and functional results.
The described technique is a minimally invasive alternative for trichobezoar removal. There is no risk of peritoneal contamination and the technical ease and short operative time in addition to an incision limited to size required for the specimen removal, makes it an attractive option.
毛石传统上通过开放手术取出，现在常采用微创手术方法。然而，通过腹腔镜切除大型毛石需要一个切口（通常4 - 5厘米大小）用于取出标本，并且存在毛发和浓缩分泌物腹腔内溢出的风险。
本文描述了一种改良的腹腔镜辅助技术，采用临时胃造口术，通过一个摄像端口和一个4 - 5厘米的切口（类似于腹腔镜手术中取出标本所需的切口）有效切除大型毛石。
3例大型毛石患者采用所述技术治疗。平均手术时间为45（30 - 60）分钟，术中失血极少。无腹腔内溢出，所有患者的毛石均可通过一个4 - 5厘米的切口取出。所有患者恢复顺利，中位随访6个月时，美容和功能效果良好。
所述技术是一种微创的毛石切除替代方法。无腹腔污染风险，技术操作简便、手术时间短，且切口仅限于取出标本所需的大小，使其成为一个有吸引力的选择。
