两镜联合镜法在经脐单孔腹腔镜胆囊切除术中的临床应用

目的探讨两镜联合在经脐单孔腹腔镜胆囊切除术中处理直径>5 mm的胆囊管的操作体会。方法回顾分析我院33例应用5 mm镜头辅助行经脐单孔腹腔镜胆囊切除手术资料,术中利用5 mm镜头作为视野镜,普通腔镜的10 mm施夹器械通过10 mm Troca通道处理直径>5 mm的胆囊管,以改进stryker-康基单孔器械包系统仅有一个10 mm Troca通道的缺陷。结果 33例手术均视野良好,器械操作相互无影响,无中转常规腹腔镜手术或开腹手术,平均手术时间43.5 min(30⁶0 min),无胆漏、出血、腹腔包裹性积液和脐疝等并发症发生。结论应用5mm镜头辅助进行经脐单孔腹腔镜胆囊切除术处理胆囊管直径>5 mm患者安全、可靠,可以改进stryker-康基单孔器械包系统仅有一个10 mm Troca通道的缺陷,简化手术操作,值得临床推广。

Combination of Hysteroscope and Laparoscope in the Operation of Transumbilical Single Incision Cholecystectomy

ObjectiveTo explore the experience of transumbilieal single incision cholecystectomy under laparoscope combined with hysteroscope in treatment of ductus cysticus greater than 5 mm.MethodsThe clinical data of 33 patients with gallbladder calculi or polyps underwent transom biblical single incision laparoscopic cholecystectomy were retrospectively analyzed. To deal with the limitation of troca channels, a hysteroscope with a diameter of 5mm and a clip applier with 10mm were used in treating atients whose ductus cysticus has dimension greater than 5 mm,during the operation.ResultsNo complications occrued intraoperatively or postoperatively. The operation was successfully completed without conversion to routine laparoscopic surgery or open surgery in al1 of the cases. We achieved a good vision during the operation, By this mean the operation average time was 43.5 minutes（ranged from 30 to 60 minutes）. No complications occrued intraoperatively or postoperatively.ConclusionsCombination of hysteroscope and laparoscope in the operation of transumbilical single incision cholecystectomy for patients whose ductus cysticus has dimension greater than 5 mm is feasible and safe, hysteroscope is use fulin decreasing the diifculty level of the procedure and dealing with the limitation of troca channels of Kangji medical instruments.