Boruta David M
Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey Suite 9E, 55 Fruit Street, Boston, MA 02114, USA.
Gynecol Oncol. 2016 Jun;141(3):616-623. doi: 10.1016/j.ygyno.2016.03.014. Epub 2016 Mar 16.
The preferred surgical approach for many gynecologic oncology procedures is now laparoscopy. Reduced morbidity, shorter hospitalization and a more rapid recovery have been associated with minimally invasive surgical approaches when compared to laparotomy. Incisional morbidity, including vascular and viscous injury, postoperative hernia, infection, and pain remain significant concerns. Use of fewer and smaller incisions during laparoscopy may be expected to further minimize these risks. Laparoendoscopic single-site surgery (LESS), or single incision laparoscopy, describes the use of one small skin incision to complete laparoscopic surgical procedures. Recent advances in instrumentation have allowed increasingly complex procedures in gynecologic cancer patients to be completed. This review will serve as an update in regards to implementation of LESS in gynecologic oncology. Technical challenges encountered during performance of LESS as well as strategies to overcome these challenges will be discussed.
如今，许多妇科肿瘤手术的首选手术方式是腹腔镜手术。与开腹手术相比，微创外科手术方式具有发病率降低、住院时间缩短和恢复更快的特点。包括血管和脏器损伤、术后疝气、感染和疼痛在内的切口并发症仍是重大问题。腹腔镜手术中使用更少、更小的切口有望进一步降低这些风险。经脐单孔腹腔镜手术（LESS），即单切口腹腔镜手术，是指通过一个小的皮肤切口来完成腹腔镜手术操作。器械的最新进展使得越来越复杂的妇科癌症患者手术得以完成。本综述将作为LESS在妇科肿瘤学中应用的最新进展。将讨论在进行LESS时遇到的技术挑战以及克服这些挑战的策略。
