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联合腹部手术中的单孔腹腔镜手术。

Single-port endo-laparoscopic surgery in combined abdominal procedures.

作者信息

Kim Guowei, Lomanto Davide, Lawenko Michael M, Lopez-Gutierrez Javier, Lee-Ong Alembert, Iyer Shridhar Ganpathi, Cheah Wei Keat, So Jimmy Bok Yan, Tsang Charles Bih Shiou, Fong Yoke Fai

机构信息

Department of Surgery, National University Health System, 5 Lower Kent Ridge Road, Singapore.

出版信息

Asian J Endosc Surg. 2013 Aug;6(3):209-13. doi: 10.1111/ases.12037.

Abstract

Single-port endo-laparoscopic surgery has gained support in the surgical community because it is perceived to offer a better postoperative outcome as it requires only a single incision. We write this prospective observational study to ascertain the feasibility and safety of this technique in patients otherwise requiring two operations. Five patients who underwent double procedures with a single-port device were reviewed: Case 1, a transabdominal preperitoneal hernia repair and gastric wedge resection; Case 2, cholecystectomy and diaphragmatic hernia repair; Case 3, oophorectomy and incisional hernia repair; Case 4, anterior resection of the rectum and hepatic segmentectomy; and Case 5, left adrenalectomy and cholecystectomy. Patient demographics, type of port used, operative time, complications and incision length were collected. Mean operative time for the cases ranged from 100 to 315 min. Incision length for the single-port device was 2 cm. In Case 2, an additional 5-mm port was used and an intraoperative complication involving a laceration of the liver occurred during the suturing of the gallbladder fundus. An additional 8-cm lower abdominal incision (Pfannenstiel) was required in Case 4 to complete the colonic anastomosis and for specimen retrieval. Single-port endo-laparoscopic surgery is a feasible and safe technique for approaching double procedures. It drastically reduces the number of scars that a double procedure creates, and if difficulty arises, another port can always be added to ease the operation. It can also potentially reduce the number of admissions and anesthesia that a patient undergoes.

摘要

单孔腹腔镜手术已在外科界获得支持,因为它被认为能带来更好的术后效果,因为它只需要一个切口。我们开展这项前瞻性观察性研究,以确定该技术在原本需要进行两次手术的患者中的可行性和安全性。对5例使用单孔装置进行双重手术的患者进行了回顾:病例1,经腹腹膜前疝修补术和胃楔形切除术;病例2,胆囊切除术和膈疝修补术;病例3,卵巢切除术和切口疝修补术;病例4,直肠前切除术和肝段切除术;病例5,左肾上腺切除术和胆囊切除术。收集了患者的人口统计学数据、使用的端口类型、手术时间、并发症和切口长度。这些病例的平均手术时间为100至315分钟。单孔装置的切口长度为2厘米。在病例2中,额外使用了一个5毫米的端口,在缝合胆囊底部时发生了术中并发症,涉及肝脏撕裂。在病例4中,需要额外做一个8厘米的下腹部切口(Pfannenstiel切口)来完成结肠吻合和取出标本。单孔腹腔镜手术是一种可行且安全的用于进行双重手术的技术。它极大地减少了双重手术造成的疤痕数量,并且如果出现困难,总是可以增加另一个端口以方便手术。它还可能减少患者的住院次数和麻醉次数。

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