改良的二孔腹腔镜肾囊肿开窗术

目的：探讨改良的二孔腹腔镜法在肾囊肿开窗术中的运用、推广价值.方法：分析运用改良的二孔腹腔镜法行肾囊肿开窗术患者的临床资料30例.手术方法：取腋中线髂棘上2横指偏腹侧小切口,长约1.5～2.0 cm（a孔）,手指内推腹膜,在手指引导下取腋后线12肋缘下（b孔）置0.5 cm套管.0.5 cm套管和1.0 cm套管分别从8号手套食指和中指穿过,和手套一起进入a孔,将手套的手腕部分反盖在a孔周围,予手术皮肤贴膜将手套的手腕部分紧贴在患者腰部皮肤.常规游离肾囊肿表面,行囊肿开窗术,从b孔取出标本,a孔放置引流管.结果：手术时间10～35 min,平均25 min;术后住院2～4天,平均3天.随访时间2～3个月,未出现相关并发症.结论：使用普通的腹腔镜器械进行改良二孔腹腔镜肾囊肿开窗术是安全可行的,伤口美观,效果良好.并且在此熟练的基础上可以同样开展其他后腹腔手术,具有推广运用价值.

Modified Two-Hole Laparoscopic Fenestration of Renal Cyst

Objective： To evaluate the apply and value of modified two-hole laparoscopic fenestration of renal cyst. Methods：Analysis the clinical data of 30 patients which received modified two-hole laparoscopic fenestration of renal cyst. The incision of abdominal wall is 1.5-2.0 cm（hole a） above the anterior superior iliac spine at the middle axillary line. Push the peritoneum with finger,put another 0.5 cm Trocar under the rib（hole b）at the rear axillary line under the guide of finger. The 0.5 em and 1.0 cm Trocars penetrate the finger and middle finger of glove, respectively, and then enter the hole a, using the sticking membrane paste the wrist of the glove on the waist. Dissociate the surface of renal cyst and performed the cyst fenestration. Takeout specimen from hole b and place drainage tube through hole a. Results： All 30 cases were treated successfully with two-hole laparoscopy, the operative time ranged from 10 to 35 min（mean 25 min）. The mean time of hospital stay was 2-4 d（mean 3 d） ; the mean hospital stay was 4.5 d. No complications were appeared after 2-3 mouths Follow-up. Conclusions：Two hole laparoscopic fenestration of renal cyst with traditional laparoscopic instruments is safe and feasible, with smaller wound and good effect. Other retroperitoneal operation also can be done in this way in the future.