经脐单孔腹腔镜技术治疗精索静脉曲张54例临床观察

目的探讨经脐单孔腹腔镜技术治疗精索静脉曲张的临床价值。方法施行经脐单孔腹腔镜精索静脉高位结扎术54例,其中左侧30例,双侧24例。沿脐缘1.5～2.0cm弧形切口逐层游离显露腹直肌鞘后,分别向左右两侧外下方45°角游离皮下组织1cm;弧形切口正中穿入气腹针建立气腹,于右侧外下方45°角远端处穿刺10mm Trocar（tro-car1）,并连接气腹机,于切口中间及左侧外下方45°角远端处分别穿刺自制软质5mm Trocar（trocar2,3）;中间5mmTrocar（trocar2）置入5mm腹腔镜,左右5mm（trocar3）及10mm Trocar（trocar1）分别置入可弯曲及相应操作器械进行操作。结果 54例手术均获成功,无并发症发生,平均手术时间单侧18min,双侧25min,术后平均住院1天。结论经脐单孔腹腔镜精索静脉高位结扎技术,效果确切、创伤更小、恢复更快、美容效果更好,并可同时施行双侧手术,值得临床推广应用。

Treatment of varicocele by transumbilical single port laparoscopy

Objective To investigate the method of transumbilical single port laparoscopy in the treatment of varicocele.Methods 54 cases were underwent transumbilical single port aparoscopic high ligation of spermatic vein（30 cases on the left side,24 cases on both sides）.Cut in layer by layer to dispose the vagina musculi recti abdodminis through a 1.5-2.0 cm curve incision on the edge of the navel.Strip subcutaneous tissue for 1cm with an angle of 45°downward to the body side on both left and right.Puncure in the pneumascos needle in the middle of the curve incision to form pneumoperitoneum.Puncture in a 10mm trocar（trocar 1） at the distal point of the 1cm stripping area to the right body side and connect it to the pneumopertoneum machine.Puncture in a self-made soft 5mm trocar beside the pneumascos needle（trocar2） and at the distal point of the 1cm stripping area to the left body side（trocar 3） respectively.Place a laparoscope in trocar 2,and other corresponding flexible devices in trocar 1 and trocar 3 respectively to operate.Results All of the operations were performed successfully and no complication had been noted.The average operative time was 18min on the 1eft side and 25min On both sides.Mean postoperative hospital stay was 1d.Conclusion Transumbilical single port laparoscopic high ligation of spermatic vein is effective to treat varicocele and is worthy to be recommended because of its advantages of less interferences,few complications,quick recovery,and low recurrence rate..