单切口经脐三角腹腔镜150例手术经验总结

目的:腹腔镜手术因取出标本而留下的手术瘢痕,影响到切口美容效果,导致切口周围感觉、运动障碍。单切口经脐三角腹腔镜(single-incision triagulated umbilicus surgery,SITUS)技术已成功应用于多种腹部外科手术,与传统腹腔镜技术相比,在皮肤美容效果上具有优势,操作便利度和学习曲线基本相同。本研究旨在总结150例SITUS手术患者的临床资料,探讨SITUS技术在腹腔脏器切除手术的可行性、安全性。方法:回顾性分析2015年8月—2020年9月我院实施的150例SITUS泌尿外科手术,总结分析手术时间、术中失血量、术后留置引流管时间、术后住院天数、患者瘢痕评估问卷(PSAQ)评分等临床数据。结果:150例手术均顺利完成,无中转开放手术或传统腹腔镜手术,所有手术标本自脐部新月形切口拉伸后取出。腹腔内手术结束后,向心性缝缩切口,术后美容效果满意。围手术期未发生ClavienⅢ级以上并发症。结论:SITUS手术方式进行腹盆腔脏器切除手术安全可行,术后瘢痕可隐藏于脐周围。尤其对于大体积标本切除患者,SITUS除了具有美容优势,还具有功能恢复上的优势。

Experience of single incision triangulated umbilicus surgery in 150 cases

Objective:The surgical scar caused by conventional laparoscopic surgery may affect the cosmetic effect and cause sensory and motor disorders.Laparoscopic single incision triangulated umbilicus surgery(SITUS)has been successfully applied in many abdominal surgeries,which showed the advantages of the cosmetic effect over conventional laparoscopy with almost equal operative difficulty and equal learning curve.The purpose of this study is to summarize the clinical data of 150 cases of SITUS and to investigate the feasibility and safety of SITUS.Methods:From August 2015 to September 2020,150 cases of SITUS with organ resection were performed,and clinical data were analyzed retrospectively.The clinical data such as operation time,estimated blood loss,postoperative drainage tube time,postoperative hospital stay and PSAQ score were analyzed.Results:All 150 procedures were successfully completed without conversion to open surgery or conventional laparoscopic surgery.All surgical specimens were removed from the crescent incision around the umbilicus.After suturing the incision,the cosmetic effect was satisfactory,and no patients suffered complications greater than or equal to Clavien GradeⅢ.Conclusion:SITUS is safe and feasible for large abdominal and pelvic organ resection operations.The incision scar can be hidden in the edge of umbilicus.SITUS not only has the advantages of cosmic effect,but also has the advantages of functional recovery,especially for patients with large specimens.