Hem-o-lok结扎锁在腹腔镜阑尾切除术中的应用

目的总结腹腔镜阑尾切除应用Hem-o-lok结扎锁处理阑尾根部的经验。方法 2009年5月～2011年6月对284例急性阑尾炎和40例慢性阑尾炎急性发作行腹腔镜阑尾切除术,超声刀切断系膜至阑尾根部,16 mm Hem-o-lok结扎锁(Weck Closure Systems)处理阑尾根部。根部近心端1～2枚Hem-o-lok结扎锁夹闭,远心端以超声刀切断。结果 324例均顺利完成手术,未发生严重并发症。阑尾根部处理顺利,所有病例均用结扎锁完成,无结扎锁滑脱现象。手术时间20～70 min,平均35 min。术中出血2～20 ml,平均10 ml。术后住院3～5 d,平均4 d。300例随访5～14个月,平均7个月,无切口感染、再发右下腹痛等发生。结论腹腔镜阑尾切除术中应用Hem-o-lok结扎锁处理阑尾根部,安全可靠,经济实用,操作方便,值得临床推广应用。

Hem-o-lok Ligating Clips in Laparoscopic Appendectomy

Objective To summarize our experience with Hem-o-lok ligating clips for managing the root of the appendix during laparoscopic appendectomy.Methods From May 2009 to June 2011,we performed laparoscopic appendectomy on 284 patients with acute appendicitis and 40 patients with chronic appendicitis.After cutting the mesoappendix to the level of the appendix root with an ultrasound scalpel,we used one or two 16-mm Hem-o-lok ligating clips(Weck Closure Systems) to secure the appendicular stump,and the distal end of the stump was dissected ultrasonically.Results The procedures were completed smoothly in all the 324 cases without leading to severe complications.No dislodgement or slippage of any Hem-o-lok ligating clips occurred.The mean operation time was 35 min(ranged from 20 to 70 min),and the mean intraoperative blood loss was 10 ml(ranged from 2 to 20 ml).The patients were discharged from hospital in a mean of 4 days(3-5 days).Follow-up was achieved in 300 of them for 5 to 14 months(mean,7 months),and none of the patients developed incisional infection or recurrent right lower abdominal pain during the period.Conclusion The Hem-o-lock clip is safe,effective and economic for managing appendicular stump during laparoscopic appendectomy.