Center of Gallbladder Disease, Institute of Gallstone Disease, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Surg Laparosc Endosc Percutan Tech. 2020 Oct;30(5):441-446. doi: 10.1097/SLE.0000000000000809.
We have designed a new gasless laparoscopic operation field formation (LOFF) device for cholecystectomy which was successfully tested on animal model. The goal of this study is to investigate the feasibility, safety and effectiveness of this LOFF device on patients undergoing cholecystectomy.
Patients with cholecystolithiasis or gallbladder polyps who underwent single port cholecystectomy from June 2015 to May 2016 were retrospectively reviewed. Either the LOFF-assisted laparoendoscopic single-port surgery (LESS) (LOFF-LESS) or the traditional LESS was performed. Operation time, intraoperative bleeding, postoperative hospital stay, surgical complications, incision pain score, shoulder and back pain and cosmetic satisfaction were compared.
A total of 186 patients were included in this study, with 79 in the LOFF-LESS group and 107 in the LESS group. There was no significant difference between LOFF-LESS group and LESS group in operation field establishment time, cholecystectomy time, intraoperative bleeding, postoperative hospital stay, incision pain and cosmetic satisfaction. A lower intraoperative arterial carbon dioxide pressure was documented in the LOFF-LESS group (P<0.01). The incidence of postoperative shoulder and back pain was significantly lower in LOFF-LESS group (P<0.01).
LOFF-LESS has comparable benefits of traditional LESS; it deceases incidence of pneumoperitoneum related complications as well.
我们设计了一种新型的无气腹腔镜手术野形成（LOFF）装置，用于胆囊切除术，并已在动物模型上成功进行了测试。本研究的目的是探讨该 LOFF 装置在接受胆囊切除术的患者中的可行性、安全性和有效性。
回顾性分析 2015 年 6 月至 2016 年 5 月期间接受单孔胆囊切除术的胆囊结石或胆囊息肉患者。采用 LOFF 辅助腹腔镜单孔手术（LESS）（LOFF-LESS）或传统 LESS 进行手术。比较手术时间、术中出血量、术后住院时间、手术并发症、切口疼痛评分、肩背部疼痛和美容满意度。
本研究共纳入 186 例患者，其中 LOFF-LESS 组 79 例，LESS 组 107 例。LOFF-LESS 组与 LESS 组在手术野建立时间、胆囊切除术时间、术中出血量、术后住院时间、切口疼痛和美容满意度方面无统计学差异。LOFF-LESS 组术中动脉二氧化碳分压明显较低（P<0.01）。LOFF-LESS 组术后肩背部疼痛发生率明显较低（P<0.01）。
LOFF-LESS 与传统 LESS 具有相似的优势；它还减少了气腹相关并发症的发生率。
