无气腹单孔腹腔镜胆囊切除术
Gasless single incision laparoscopic cholecystectomy
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摘要:单孔腹腔镜手术(LESS)理念的提出符合微创外科时代的发展趋势｡该技术能否普及应用,关键是解决气腹状态下狭窄的单孔通道问题｡2012年2月至9月首都医科大学宣武医院采用腹壁皮下悬吊无气腹腹腔镜技术,为34例胆囊疾病患者实施无气腹单孔腹腔镜胆囊切除术｡34例患者手术均获成功,无中转常规腹腔镜手术及开腹手术｡手术时间为45~135min,平均手术时间为70min｡术中出血量为5~40ml,术中平均出血量为18ml｡术后住院时间为3~4d,术后平均住院时间为3.4d｡术后3周复查,脐部切口瘢痕隐蔽,腹壁美观｡利用腹壁皮下悬吊无气腹腹腔镜技术的优点和LESS的操作特点,降低LESS的技术难度,有利于此类手术的推广和普及｡Abstract:Laparoendoscopic single site (LESS) surgery is in line with the development trend of minimally invasive surgery. Resolving the problems caused by the tiny single trocar is very important for the popularizing of LESS surgery. From February to September in 2012, 34 patients with cholecystolithiasis or polypoid lesions of the gallbladder received gasless singleincision laparoscopic cholecystectomy at the Xuanwu Hospital. All the operations were successfully done, with no conversion to conventional laparoscopic surgery or open surgery. The mean operation time, intraoperative blood loss and duration of postoperative hospital stay were 70 minutes (range,45-135 minutes), 18 ml (range,5-40 ml) and 3.4 days (range,3-4 days). There was no complication within the follow up of 3 weeks, and all patients recovered well with satisfied cosmetic effect. Combination of gasless single incision laparoscopic techniques could decrease the difficulty of LESS surgery and help to popularize LESS surgery.
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