经脐腹壁内三通道单孔腹腔镜胆囊联合阑尾切除术应用体会

目的探讨经脐腹壁内三通道单孔腹腔镜行胆囊、阑尾联合切除的可行性及临床价值。方法回顾性分析2011年1月至2013年3月收治的40例经脐腹壁内三通道单孔腹腔镜行胆囊、阑尾联合切除患者的临床资料。结果40例患者均顺利完成手术，无中转开腹及死亡病例，手术时间60-80min，平均70min，术后无切口感染、创面出血、胆道损伤、阑尾残端瘘及腹腔残余脓肿发生，术后均未用止痛药，1个月后切口无瘢痕，美容效果显著。随访半年，患者对术式评价优良。结论术者具有娴熟的腹腔镜操作技能，且掌握适应证及原则，经脐腹壁内三通道单孔腹腔镜行胆囊、阑尾联合切除是可行的，且安全有效，术后切口无瘢痕，美容效果明显。

Application experience of transumbilical abdominal wall within the three-channel single-incision laparoscopic combined cholecystectomy and appendectomy

Objective To explore the clinical valuation and feasibility of transumbilical abdominal wall within the three-channel sing/e-incision laparoscopic combined cholecystectomy and appendectomy. Methods The clinical data of 40 patients who underwent transumbilical abdominal wall within the three-channel sing/e-incision laparoscopic combined cholecystectomy and appendectomy from January 2011 to March 2013 were retrospectively analyzed. Results Forty patients were successfully completed surgery, no transfer laparotomy and death cases, surgery time was 60 - 80 min, average 70 min, without postoperative incision infection, wound bleeding, bile duct injury, appendix stump fistula and abdominal residual abscess, neither postoperatively used analgesics, 1 month after without incision scar, cosmetic effect was remarkable. Half a year＇s follow-up,the excellent operation evaluation. Conclusions The performer should have accomplish laparoscopie operation skills,and master the indications and the principle.The method of transumbilical abdominal wall within the three-channel sing/e-incision laparoseopie combined choleeystectomy and appedeetomy is safe, feasible and valid. The postoperative wound is more minimally invasive and aesthetic effect is obvious.