Selvaraj Nivash, Dholakia Kunal, Ramani Srivathsan, Ragavan Narasimhan
Department of Urology, Apollo Main Hospitals, Chennai, India.
Surg Open Sci. 2021 Feb 17;4:37-40. doi: 10.1016/j.sopen.2021.02.001. eCollection 2021 Apr.
Large-size ports used for laparoscopic and robotic procedures will require appropriate closure to reduce the probability of trocar site complications including hematoma and hernia. Closure of these ports is done by various methods like the open method extending skin incisions, S-retractor, Carter Thomason method, and so on. Chennai port closure (CHC) method, a novel technique that had been in practice in our unit for more than 2 years, ensures direct visualization of the suture placement, and hence, the abdominal wall fascia and peritoneum are secured.
We herein describe an easy technique for fascial closure in port size (≥ 10 cm) after minimally invasive surgery, including both laparoscopic and robotic procedures, using a cobbler needle in 151 patients in the study period between February 2017 and March 2020 for various urological procedures. This technique was done before the introduction of the trocar sheath and ensures direct visualization of the abdominal fascial closure.
There were no major intraoperative events, additional operating time, and need for any costly instruments. No bowel injuries or trocar site hernias were documented during a mean follow-up of 28 months. Presently, this technique is used by many surgeons in our hospital without much difficulty.
The Chennai port site closure technique is an effective, simple, easy-to-apply, and safe procedure.
用于腹腔镜和机器人手术的大尺寸端口需要适当关闭，以降低套管针穿刺部位并发症（包括血肿和疝气）的发生概率。这些端口的关闭可通过多种方法完成，如延长皮肤切口的开放法、S形牵开器、卡特·托马森法等。钦奈端口关闭（CHC）法是一种在我们科室已应用两年多的新技术，可确保直接观察缝线放置情况，从而固定腹壁筋膜和腹膜。
本文描述了一种在2017年2月至2020年3月研究期间，对151例接受各种泌尿外科手术的患者，在微创（包括腹腔镜和机器人）手术后，使用补鞋匠针关闭≥10厘米端口大小的筋膜的简便技术。该技术在插入套管针鞘之前进行，可确保直接观察腹部筋膜的关闭情况。
术中无重大事件发生，无额外手术时间，也无需任何昂贵器械。在平均28个月的随访期间，未记录到肠损伤或套管针穿刺部位疝气。目前，我院许多外科医生使用该技术时并无太大困难。
钦奈端口关闭技术是一种有效、简单、易于应用且安全的手术方法。
