经脐单孔腹腔镜胆囊阑尾联合切除术16例报告

目的探讨经脐单孔腹腔镜胆囊阑尾联合切除术的临床应用价值。方法回顾性分析我院2010年7月～2012年1月16例经脐单孔腹腔镜胆囊阑尾联合切除术的临床资料。经脐置入多孔道trocar,曲线形腹腔镜器械先切除胆囊并使用推结器丝线打结结扎胆囊动脉及胆囊管,然后行阑尾切除,4例由脐孔行拖出式阑尾切除,12例应用常规腹腔镜器械切除阑尾并使用推结器丝线打结结扎阑尾动脉及阑尾根部。结果 16例均获成功,未放置引流。手术时间60～150 min,平均80.4 min,无并发症发生。结论使用专用器械行经脐单孔腹腔镜胆囊阑尾联合切除术安全、可行,但较传统腹腔镜手术操作困难,需要有一个学习曲线。

Transumbilical Single-port Laparoscopic Cholecystectomy and Appendectomy:Report of 16 Cases

Objective To investigate the efficacy of transumbilical laparoscopic cholecystectomy(LC) and laparoscopic appendectomy(LA) with a single port and free clips.Methods The clinical data of 16 patients,who received transumbilical single-port LC plus LA in our hospital from July 2010 to January 2012,were analyzed retrospectively.A multi-channel trocar was inserted through the umbilicus,and then cholecystectomy were performed with curved laparoscopic instruments.After the cystic artery and duct were ligated with a knot pusher,LA was carried out.The appendix was pulled out through the umbilicus in 4 patients,and in the other 12 patients,appendectomy was made with conventional laparoscopic instruments,and the appendix artery and stump were ligated with a knot pusher.Results The procedure was completed in all the 16 patients without placing drainage tube.The operation time ranged from 60 to 150 minutes with a mean of 80.4 min.No patient had complications.Conclusions Transumbilical single-port LC and LA are feasible and safe,but more difficult than conventional laparoscopic procedure.A learning curve is expected.