经最佳微创化操作孔腹腔镜联合手术的临床研究

目的总结腹腔镜下联合脏器手术的临床经验，探讨经最佳微创化操作孔行腹腔镜联合手术的临床应用价值。方法回顾分析2004年10月-2008年12月间72例腹腔镜联合手术的临床资料，研究不同类型的联合术腹壁穿刺孔布局、数量的合理性及运用技巧。结果72例腹腔镜联合手术均获成功，无严重并发症发生及中转开腹，手术时间50～150min，平均88．89min，术后3—6d痊愈出院。结论合理布局及灵活运用腹壁操作孔行腹腔镜联合手术既保证能安全有效地处理多种疾病，又能节省手术时间，只有做到最少操作孔数量与最短手术时间的有机统一，才能减少手术创伤的总量，从而达到最佳微创化效果。

Clinical Research on Combined Procedures in Laparoscopic Surgery Through Optimal Minimally Invasive Operating Hole

Objective To summarize the clinical experience of combined procedures in laparoscopic surgery, to explore the clinical value of combined procedures in laparoscopic surgery through optimal minimally invasive operating hole. Methods The clinical data of 72 cases with abdominal diseases by combined procedures in laparoscopic surgery from October 2004 to December 2008 was retrospectively analyzed, The skills and rationality of the distribution and number of the puncture holes in different combined procedures were studied. Results The operations of 72 patients were performed successfully and no case was converted to open procedure and no severe complications oecured. The operative time ranged from 50 to 150min, and the average operating time was 88.89min. All patients recovered well and the postoperative hospitalization was 3 - 6 days. Conclusion Using operating hole rationally and skillfully will assure doctors deal with many kinds of diseases safely effectively as well as saving operating time. Only the organic unity of minimum operating hole and shortest operating time can reduce operating trauma and maintain optimal minimally invasive effect.