经脐单孔腹腔镜精索内静脉高位结扎术(附24例报告)

目的 探讨经脐单孔腹腔镜在精索内静脉高位结扎手术中的应用. 方法 24例精索静脉曲张患者,均行经脐单孔腹腔镜精索内静脉高位结扎术,其中单纯左侧15例,双侧9例. 结果 24例患者手术均取得成功,单侧手术时间平均(42.3±10.2)min,双侧手术时间平均(58.4±9.7)min,术中出血量平均(15.4 ±5.2)ml.无中转开放手术,术中无肠管损伤、睾丸动脉误扎,术后无穿刺口出血、感染,无阴囊血肿,无腹壁穿刺处疝形成.术后6个月复查精液常规,精子密度计数及精子活率较术前明显提高(P＜0.01或P＜0.05). 结论 经脐单孔腹腔镜行精索内静脉高位结扎术治疗精索静脉曲张是安全可行的,随着器械的不断改进和完善,单孔腹腔镜手术具有更广阔的发展前景.

Trans-umbilical Single-port Laparoscopic Varicocelectomy for Varicocele:A Report of 24 Cases

Objective To explore the trans-umbilical single-port laparoscopic in varicocelectomy.Method 24 varicocele patients were performed high ligation of vena spermatica interna by trans-umbilical single-port laparoscopy,including left-side surgery in 15 cases and bi-lateral surgery in 9 cases.Results 24 cases were finished the laparoscopic surgery successfully,and no one conversed to open surgery.The unilateral and bilateral average operative time was(42.3±10.2) and(58.4±9.7) minutes respectively,and the average intra-operative blood loss was(15.4±5.2) ml.No complications such as injury of intestinal canal,mis-ligation of funicular artery,hemorrhage and infection of puncture stoma,hematoma of scrotum and lateral ventral syndrome of puncture abdominal wall occurred during or post operation.Semen was re-examed 6 months after the operation.Compare with pre-operation,both the sperm count and motility rate were obviously increased(P<0.05 or P<0.01).Conclusion The trans-umbilical single-port laparoscopic varicocelectomy is safe and feasible for varicocele,and it will reveal a broader development along with the improvement of single-port laparoscopic instruments.