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经脐单孔腹腔镜阑尾切除术32例应用体会(1)
http://www.100md.com 2011年11月15日 王刚 薛志祥 赵学良
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     [摘要]目的 探讨经脐单孔腹腔镜阑尾切除术的临床应用和治疗体会。方法 为32例急慢性阑尾炎患者行阑尾切除术,应用普通腹腔镜器械及改良Trocar,经脐单孔完成手术。结果 28例成功完成经脐单孔腹腔镜阑尾切除术,手术时间25~55min,平均40min。4例转为三孔法腹腔镜阑尾切除术,无中转开腹。术后恢复顺利,无出血、肠漏等并发症出现,平均住院4d。术后随访3个月,无并发症发生,切口美容效果满意。结论 经脐单孔法腹腔镜阑尾切除术具有微创化、充分体现患者创伤小、痛苦少、恢复快、隐蔽性及美容效果好等特点。改良Trocar普通器械行经脐单孔腹腔镜阑尾切除术安全可行,便于推广,但较高的操作难度要求在部分病例中选择应用。

    [关键词]阑尾切除术;经脐单孔腹腔镜手术;改良

    [中图分类号] R656.8 [文献标识码] B [文章编号] 1673-9701(2011)32-153-02

    Trocar Single-port Transumbilicai Laparoscopic Appendectomy of 32 Cases

    WANG Gang XUE Zhixiang ZHAO Xueliang

    Surgery Department,Bozhou Huatuo Traditional Chinese Hospital,Bozhou 236800,China

    [Abstract] Objective To evaluate the clinical application and treatment experience of single-port transumbilical laparoscopic appendectomy.Methods All of 32 cases patients with acute or chronic appendicitis received single-port transumbilical laparoscopic appendectomy,with the application of ordinary laparoscopic instruments and improvements Trocar.Results All 28 cases of patients received successful single-port transumbilical laparoscopic appendectomy,the operative time ranged from 25 to 55 minutes,average 40 minutes. 4 cases were converted to three-port laparoscopic appendectomy,without laparotomy. Postoperative recovery was smooth, no bleeding,intestinal leakage and other complications,the average hospital stay was 4 days.During the follow-up of 3 months,no complications were observed,wound cosmetic results were satisfactory. Conclusion Single-port transumbilical laparoscopic appendectomy with a minimal invasive is minimal trauma, less pain, quicker recovery and good hidden and cosmetic effect.Single-port transumbilical laparoscopic appendectomy,with the application of ordinary laparoscopic instruments and improvements Trocar,is feasible and safe, easy to promote,however it is suggested the operation is carried out in some selected cases for the higher difficult operating skills.

    [Key words] Appendectomy;Single-port Transumbilical laparoscopic;Improved Trocar

    急性阑尾炎不仅是阑尾最主要的病变 ......

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