Wong L F A, Anglim B, Wahab N A, Gleeson N
a Department of Gynaecological Oncology , St James's Hospital , Dublin , Republic of Ireland.
J Obstet Gynaecol. 2017 May;37(4):487-491. doi: 10.1080/01443615.2016.1269226. Epub 2017 Feb 17.
Laparoscopic entry techniques vary amongst surgeons and gynaecologists, with gynaecologists favouring Veress needle entry. Recent RCOG/BSGE recommendations have recommended retrieval of ovarian masses via the umbilical port with resultant less postoperative pain and a faster retrieval time than with retrieval through lateral ports of the same size. This is a prospective observational study reviewing the Hasson entry technique and the introduction of retrieval of specimens via the umbilicus in patients scheduled for a laparoscopy procedure at our day surgery unit. We found no immediate or major surgical complications and all specimens were successfully retrieved through the umbilicus. Pain scores were low. We recommend the technique for extirpative gynaecological surgery. Impact Statement This study confirms that conversion from the closed Veress to the open Hasson technique is achievable in a university hospital setting. Operator confidence during the learning phase is enhanced by the use of ultrasound to locate and measure the depth of the umbilical ligament. Retrieval of benign adnexal specimens through the umbilicus was very satisfactory.
腹腔镜进入技术在外科医生和妇科医生中各不相同,妇科医生更倾向于使用Veress针进入。英国皇家妇产科医师学院/英国妇科内镜学会最近的建议推荐通过脐部端口取出卵巢肿块,与通过相同大小的侧端口取出相比,术后疼痛更少,取出时间更快。这是一项前瞻性观察性研究,回顾了在我们日间手术单元计划进行腹腔镜手术的患者中使用Hasson进入技术以及通过脐部取出标本的情况。我们未发现立即或重大的手术并发症,所有标本均成功通过脐部取出。疼痛评分较低。我们推荐该技术用于妇科切除手术。影响声明 本研究证实,在大学医院环境中,从闭合式Veress技术转换为开放式Hasson技术是可行的。在学习阶段,使用超声定位和测量脐韧带的深度可增强操作者的信心。通过脐部取出良性附件标本非常令人满意。