经脐单孔腹腔镜盆腔淋巴结清扫术初步报告

目的探讨经脐单孔腹腔镜下盆腔淋巴结清扫术的可行性。方法采用经脐单孔三通道入路,腹腔镜下对3例阴茎鳞癌、1例会阴部上皮样肉瘤患者施行双侧改良的盆腔淋巴结清扫术。肚脐取一倒U型2～3cm切口,分别置入2个5mm和1个12mm穿刺器。手术操作通过可弯曲的钳、电凝钩及超声刀完成。清扫范围为髂内外血管分叉处以下的髂血管区域和闭孔附近的淋巴组织。结果 4例手术均取得成功。手术时间90～180min,平均105min;出血量70～250ml,平均126ml。无术后出血、皮下气肿、淋巴漏、神经损伤等并发症发生。结论经脐单孔腹腔镜盆腔淋巴结清扫术安全、可行,具有一定的微创美容效果。

Laparoendoscopic single-site transumbilical plevic lymphadenectomy:Four cases report

Objective To evaluate the feasibility of laparoendoscopic single～site transumbilical plevic lymphadenectomy（LESS～ TPL）.Methods Four cases（three with penile carcinoma,one with perineal epithelioid sarcoma） underwent the LESS～TPL.In all cases,a 2～3 cm single inverted U～shaped supraumbilical incision was made.Two 5 mm and one 12 mm trocars were inserted,and medical rubber glove was sutured surrounding the three trocars and incision for gas proofing.Flexible electric coagulation hook and straight ultrasound knife were used for dissection.All the nodes below the bifurcation of common iliac artery and surround the obturator nerve were cleared.Results All procedures were technically successful.The mean operating time was 105（90～180） minutes.The mean estimated blood loss was 126（70～250） ml.No intraoperative complications occurred.Conclusions LESS～TPL represents a feasible and novel mini～invasive option for selected patients who need plevic lymphadenectomy.