Nakayama Kentaro, Yoshimura Yuki, Razia Sultana, Yamashita Hitomi, Ishibashi Tomoka, Ishikawa Masako, Sasamori Hiroki, Sawada Kiyoka, Kurose Sonomi, Sato Seiya, Kyo Satoru
Department of Obstetrics and Gynecology, Shimane University, Izumo, Shimane 6938501, Japan.
Department of Obstetrics and Gynecology, Hamada Medical Center, Hamada, Shimane 6978511, Japan.
Mol Clin Oncol. 2021 Aug;15(2):160. doi: 10.3892/mco.2021.2322. Epub 2021 Jun 14.
Innovation in gynecological surgery is constantly evolving to make procedures less invasive. Minimally invasive single-port laparoscopic surgery (SPLS) is another innovation that may further improve gynecological surgery outcomes. However, SPLS is not widely used due to the technical difficulties of the procedure. Inserting several instruments through the same incision impedes proper use of the devices. Therefore, the present study aimed to find a technique to overcome this problem and make this approach more convenient. Between March 2015 and February 2020, 25 patients were treated with SPLS by a single gynecological surgeon. The range of surgery time was 50-103 min and the mean surgery time was 67.2 min. The mean bleeding volume was small (mean, 10.1 ml). No intraoperative or postoperative complications occurred in the patients. A gel port (GelPOINT Mini Medical Leaders) was inserted into the peritoneal cavity through a 3-cm Z-shaped intra-umbilical skin incision. Additionally, a small incision (3 mm) was made in the left medial portion of the iliac crest and a bladeless trocar (Versa One) was inserted. Thus, crowding of the working instruments within one incision was prevented. The addition of a small diameter port (3-mm) at the wound site left practically no scar, thus making SPLS a cosmetically superior option compared with a bigger diameter port (5-mm).
妇科手术的创新一直在不断发展,以使手术创伤更小。微创单孔腹腔镜手术(SPLS)是另一项创新,可能会进一步改善妇科手术的效果。然而,由于该手术的技术难度,SPLS并未得到广泛应用。通过同一切口插入多个器械会妨碍器械的正常使用。因此,本研究旨在找到一种技术来克服这一问题,使这种方法更便捷。2015年3月至2020年2月期间,由一位妇科外科医生对25例患者进行了SPLS治疗。手术时间范围为50 - 103分钟,平均手术时间为67.2分钟。平均出血量较少(平均为10.1毫升)。患者未发生术中或术后并发症。通过脐部3厘米的Z形皮肤切口将一个凝胶端口(GelPOINT Mini Medical Leaders)插入腹腔。此外,在髂嵴内侧左部做一个小切口(3毫米),并插入一个无刀片套管针(Versa One)。这样就避免了工作器械在一个切口内拥挤。在伤口部位增加一个小直径端口(3毫米)几乎不会留下疤痕,因此与更大直径端口(5毫米)相比,SPLS在美观上是一个更优的选择。