腹腔镜脐周三孔法阑尾切除术在基层医院的应用体会

目的:探讨脐周三孔法腹腔镜阑尾切除术的手术方法与可行性。方法:回顾分析2011年1月至12月为72例急性阑尾炎患者行经脐周三孔法腹腔镜阑尾切除术的临床资料。以脐为中心,沿脐周皮肤皱褶线画圆,从12点钟方向弧行切开皮肤1 cm,穿刺10 mm Trocar,探查阑尾及盆腔情况,决定行经脐腹腔镜手术后,分别于脐4、8点钟方向穿刺5 mm Trocar,游离阑尾,结扎切除阑尾。结果:72例手术均获成功,无一例中转开腹。术后无腹腔出血、切口感染及脐疝等并发症发生。手术时间30～85 min,平均40 min。术后随访瘢痕被脐皱襞掩盖,不易察觉。结论:脐周三孔法腹腔镜阑尾切除术安全可行,但操作较困难,术后腹壁瘢痕不明显。

Transumbilical laparoscopic appendectomy with three trocars in primary hospital clinical research

Objective：To investigate the feasibility of the transumbilical laparoscopic appendectomy with three trocars. Meth- ods：Clinical data of 72 patients who underwent transumbilical three-trocar laparoscopic appendectomy from Jan. 2011 to Dec. 2011 were analysed retrospectively. After making acircle incision around the umbilicus（ started from 12 o＇cloek） ,a 10 mm optical troear was introduced to observe the appendix and the pelvic cavity, afterwards,if laparoscopy was determined,two operational troears were placed at 4 o ＇clock and 8 o＇clock （5 mm） respectively to resect the appendix. Results：The operation was completed successfully in all the eases without conversion to open surgery, No intra-abdominal hemorrhage, perforation, infection or umbilical herniation occurred after the pro- cedure. The mean operation time was 40 min（30-85 min）. Follow-up showed satisfying cosmetic results in the patients. Conclusions： Transumbilical laparoscopic appendectomy is safe and feasible but difficult to carry out. Its cosmetic outcomes are satisfying.