经脐单孔腹腔镜胆囊切除术

目的 探讨经脐单孔腹腔镜胆囊切除术临床应用的安全性及疗效.方法 回顾性分析2008年1月至2010年5月第三军医大学新桥医院完成的16例行经脐单孔腹腔镜胆囊切除术患者的临床资料.取紧邻脐孔右侧缘行约1.5 cm的切口,入腹后置入连接好2个5 mm Trocar和1个10 mm Trocar所形成的三通道防漏气操作装置,制造气腹,以10 mm Trocar进入腹腔镜镜头,自2个5 mm Trocar各进入一把腹腔镜器械和5 mm超声刀,按常规腹腔镜操作方法完成胆囊切除术.结果 16例患者手术均获成功,手术时间为50～150 min,未放置引流管,术后无出血及胆汁漏等并发症发生.患者恢复良好,脐部无明显手术瘢痕.结论 经脐单孔腹腔镜胆囊切除术切口美观,安全可行.但操作难度较传统LC大,进一步完善脐部操作装置及手术器械,可望在一定程度上取代传统LC.

Transumbilical single-port laparoscopic cholecystectomy

Objective To evaluate the safety and efficacy of transumbilical single port laparoscopic cholecystectomy. Methods The clinical data of 16 patients who received transumbilical single port laparoscopic cholecystectomy at Xinqiao Hospital from January 2008 to May 2010 were retrospectively analysed. An incision with a length of 1.5 cm was made adjacent to the umbilicus, and then two 5 mm trocars and one 10 mm trocar were installed. After the establishment of pneumoperitoneum, a laparoscopic camera was placed via the 10 mm trocar,and laparoscopic instruments and a 5 mm ultrasonic scalpel were placed via the two 5 mm trocars, respectively.Cholecystectomy was performed in the same manner as for the conventional laparoscopic procedure. Results All the operations were successfully carried out. The operation time was 50-150 minutes. No drainage tube was inserted,and no complications such as bleeding or bile leakage were observed after the operation. Patients recovered well,and no scarring was observed around the umbilicus. Conclusions Transumbilical single-port laparoscopic cholecystectomy is safe and feasible, but it is more difficult than laparoscopic cholecystectomy in terms of manipulation.Transumbilical single-port laparoscopic cholecystectomy has the potential to replace laparoscopic cholecystectomy if the operative instruments are improved.