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经脐部改良腹腔镜手术套管位置评估。

Assessment of Modified Trans-umbilical Port Placement in Laparoscopy.

机构信息

Department of Gynecology and Obstrectics, MIDAT Hospital, Lagankhel.

Department of General Surgery, MIDAT Hospital, Lagankhel.

出版信息

J Nepal Health Res Counc. 2022 Jun 2;20(1):173-179. doi: 10.33314/jnhrc.v20i01.3937.

Abstract

BACKGROUND

Primary port placement is a critical step in any laparoscopic procedure. Although the safety and efficacy of open versus closed technique has been much debated, no particular technique is considered as the best. Therefore, over the period of time different methods have been developed and applied in order to perform laparoscopy procedures, Midat hospital has been using a version of modified trans-umbilical open technique for primary port entry from 2 decades and this study is being carried out to evaluate the technique.

METHODS

Retrospective review was conducted. The patients who underwent laparoscopy surgery by modified trans-umbilical port placement at Midat hospital from June 2019- April 2020 were included in this study.

RESULTS

A total of 100 cases were studied. Cholelithiasis was the main indication of surgery. The mean time recorded to establish pneumoperitoneum was 3.4±1.3 minutes. The rate of umbilical swab culture growth was 1%, pre-peritoneal port placements was 2%. Post-operative primary port site infection rate was 4%. No intra-abdominal injury was noted during the entry of primary port and there was no port site hematoma or recorded hernia over the period of one year.

CONCLUSION

This technique of modified trans-umbilical primary port placement is one of the safest, fastest and easiest techniques to enter the peritoneal cavity.

摘要

背景

主端口放置是任何腹腔镜手术的关键步骤。虽然开放式与封闭式技术的安全性和有效性已经进行了大量的讨论,但没有一种特定的技术被认为是最好的。因此,在过去的一段时间里,为了进行腹腔镜手术,已经开发并应用了不同的方法,米达特医院已经使用改良经脐开放式技术的一种版本进行主端口进入,这项研究旨在评估该技术。

方法

进行了回顾性研究。本研究纳入了 2019 年 6 月至 2020 年 4 月期间在米达特医院接受改良经脐端口放置腹腔镜手术的患者。

结果

共研究了 100 例病例。胆结石是手术的主要指征。建立气腹的记录时间平均为 3.4±1.3 分钟。脐拭子培养物生长率为 1%,腹膜前端口放置率为 2%。术后主端口部位感染率为 4%。在进入主端口时未发现腹腔内损伤,在一年的时间内没有记录到端口部位血肿或疝。

结论

改良经脐主端口放置技术是进入腹腔最安全、最快和最简单的技术之一。

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