脐部单切口三孔腹腔镜肾上腺全切术初步经验

目的：探讨脐部单切口三孔腹腔镜肾上腺全切手术可行性及初步治疗经验。方法：4例患者，男2例，女2例，平均35（32-45）岁。左侧3例，右侧1例。根据脐部形状在脐部作3．0cm左右的切口，插入二根10mm套管和一根5mm套管作为窥视孔及操作孔，腹腔镜下常规操作，完成肾上腺全切手术。手术操作通过腹腔镜器械及超声刀完成。肾上腺中央静脉用Hem-o-lok结扎并切断，标本放入标本袋后经切口取出。结果：平均手术时间90（70～151）min，术中出血量平均100（90～150）ml，术后平均排气时间8（6～12）h。平均住院时间7（6～9）天，术后4例随访平均3个月。脐部切口愈合好，腹部无可见瘢痕，无脐疝及肠梗阻等并发症。结论：经脐单孔腹腔镜下肾上腺全切除术安全可行，脐部切口美观，具有较好的微创效果，远期的临床效果需要进一步观察。

Three Holes Umbilical Plexus Single Incision Laparoscopic Treatment Adrenal Complete Initial Experience

Objeetive：Single incision three holes umbilical plexus laparoscopic surgery feasibility and the adrenal preliminary treatment experience. Methods： Four patients,two male and two female, average age 35 （32-45）. The lesion of 3 cases were in the right side. 3.0 cm of incision was made according to the umbilical plexus shape just around the umbilical plexus,Two 10 mm casing and a peephole 5 mm casing were inserted as well as the the regular operations, and the laparoseopie adrenal gland operation was completed,during which the operation of laparoscopic instruments and ultrasonic knife were used. Adrenal main vein was ligated by hemoclips, specimens were put out by ligation specimen bag through incision. Results：The average time was 90 （70-151） rain, peri-operative bleeding was average 100 （90-150） ml, postoperative average exhaust time 8 （6-12）. The average hospitalised time was 7 （6-9） d, average follow-up time was 3 months. No hilum hernia and scar tissue complications like intestinal obstruction happened. Conclusion： the hilum single-arch laparoscopic resection of adrenal gland is safe and feasible, adrenal umbilical plexus incision has nice outlook the long-term clinical minimally invasive results need further observation.