单切口腹腔镜与传统腹腔镜阑尾切除术比较

目的 介绍单切口腹腔镜下阑尾切除术的方法和体会.方法 选取我院2009 年10 月-2010 年3 月50 例阑尾炎患者,在脐周建立三戳孔,对称安置3 个Trocar(1 个12mm Trocar,2 个5mm Trocar),腹腔镜下切除阑尾并以12mm Trocar 或扩切至20mm( 国际惯例认定:切口长度>20mm 的切口称之为单切口) 将标本取出.若阑尾标本较粗大,可将其中2 个5mmTrocar 孔或1 个5mm Trocar 和12mm Trocar 融合成新的单切口,然后将标本取出.传统的三孔法腹腔镜下阑尾切除术(50例),即在腹部正中线脐旁5mm 处置入5mmTrocar,脐下6-7mm 处置入12mm Trocar,反麦氏点置入5mm Trocar 进行手术.结果 平均手术时间15min(10-20min),住院时间2-3d,腹部未见明显瘢痕,均无切口感染,50 例患者均未见阑尾残株炎、肠粘连等并发症.结论 单切口腹腔镜下阑尾切除术操作简单,创伤极小,手术安全.

Single-incision laparoscopic appendectomy and traditional triple-hole laparoscopic appendectomy:A comparative study

Objective To describe the methods of single-incision laparoscopic appendectomy and our experience with it.Methods Fifty patients with appendicitis admitted to our hospital from October 2009 to March 2010 were enrolled in this study.The patients underwent single-incision laparoscopic appendectomy with 3 trocars inserted around the umbilicus(one was 12mm long and two were 5mm long).The incision was called a single incision when its length was >20mm.The appendix was pulled out from the 12mm-long trocar.If the appendix was large,two 5mm-long trocars or one 5mm-long trocar was fused into a single incision to form a new single incision to remove the appendix.Then,the outcomes of single-incision laparoscopic appendectomy and traditional triple-hole laparoscopic appendectomy were compared.Results The average operation time of single-incision laparoscopic appendectomy was 15min(range 10-20min).The hospital stay time of the patients was 2-3days after operation.No obvious abdominal scar formation,incision infection,appendix stump inflammation and adhesion occurred after operation.Conclusion Single-incision laparoscopic appendectomy is a simple and safe procedure for appendicitis with extremely small trauma.