常规腹腔镜器械在经脐单孔阑尾切除术中应用体会

目的总结将常规腹腔镜器械应用于经脐单孔阑尾切除术的经验及体会,探讨其方法的可行性及安全性。方法全麻下取头低脚高仰卧位,经脐部单切口置入双Trocar,经右下腹壁体外缝线悬吊阑尾,镜下用分离钳分离出阑尾根部及系膜血管,体外打滑结用推结器分别套扎处理阑尾根部及系膜血管,阑尾残端不做荷包缝合包埋。结果 21例完成手术,无出血、粪瘘、切口感染等并发症出现。脐部切口均Ⅰ期愈合。术后疼痛轻微,均痊愈出院。脐部切口疤痕极为隐蔽。结论常规腹腔镜器械应用于经脐单孔阑尾切除术,安全可行,设计巧妙,减少了相互干扰,简化了操作步骤,创伤小,恢复快,美容效果明显,具有临床实用价值,适合各级医院开展。

The experiences of applying routine laparoscopic appliance to transumbilical single - incision laparoscopic appen-dectomy

Objective To summarize the experiences of applying routine laparoscopic appliance to transumbilical single - incision lapa-roscopic. Appendectomy and explore the feasibility and security of this surgical technique. Methods After general anesthesia , the patient should be lied at supine position while the head lower and legs higher, we put two trccars transit the single incision in the umbilicus and hang up the appendix with a line outside the abdominal cavity from the lower right abdominal wall. We separated the root and mesenry of the appendix using elastic separating plier, and ligated either of them with slip knots which were put into abdominal cavity using a slip knot pusher . The ap-pendiceal stump was left without enbedded with purse string suture. Results The 21 cases were successfully done by laparoscopy, no compli-cation was found,such as postoperative hemorrhage,fecal fistula,infection of incisional wound and so on. The incisions in the umbilicus all healed by first intention. Patients aked more slightly after operation and all recoverd well. Conclusion It is safe and simple to apply routine Laparoscopic appliance to transumbilical single - incision laparoscopic appendectomy. The method is cleverly designed to reduce the interfer-ence of the instruments. The operation is more minimal invasive and aesthetic,which is worth promoting at all levels of hospital.