用SilsPort行单一切口腹腔镜胃内手术的可行性研究

目的探讨SilsPort行单一切口胃内手术的可行性、安全性与有效性。方法 6头家猪作为实验对象,将SilsPort经腹壁切口置入胃内。3头猪用超声刀切开胃后壁黏膜层,切开长度3 cm,3-0可吸收线间断缝合;另3头猪用抓钳抓取胃后壁组织,用直线切割吻合器切除。结果所有模拟操作均顺利完成,无明显术中出血与并发症。放置SilsPort所用时间为8~40 min,（16.2±12.2）min。3头猪用直线切割吻合器行模拟切除总手术时间分别为75、45、38 min;另3头猪用超声刀模拟切除缝合所用时间分别为80、85、70 min。术后活检见胃前壁缝合良好,胃内模拟切除部位缝合（或钉合）满意,局部无出血。结论用SilsPort进行胃内手术可行、安全,提供了将腹腔镜与器械置入胃内进行手术操作简便、稳定的平台。

Single Incision Laparoscopic Intragastric Surgery by Using SilsPort: a Feasibility Study on Porcine Model

Objective The aim of this study is to evaluate the feasibility,safety and efficiency of single incision laparoscopic intragastric surgery by using SilsPort. Methods Six pigs were used in this study.The SilsPort was introduced into the arterial wall of the stomach through a 3-cm abdominal incision.Two simulated operative maneuvers were performed,including gastric mucosa resection and suturing,and mucosa resection by using staplers,each in three pigs respectively.Operation time,intraoperative blood loss and postmortem examination results were recorded. Results All the procedures were completed successfully in the six pigs without intraoperative massive hemorrhage and complications.The time for setting up the intragastric ports ranged from 8 to 40 min（mean,16.2±12.2 min） and it decreased with experience.The total operation time for the 3 pigs that received partial gastric mucosa resection by using staplers was 75,45,and 38 minutes;and for the other 3 pigs in which partial resection was performed by ultra shear and suturing was 80,85,and 70 minutes respectively.Postmortem examination revealed that the simulated resected sites were clear without leakage and bleeding.Conclusion Simple and stable intragastric surgery platform can be set up by introducing the SilsPort into the stomach,which can safely decrease the operation time and make the technique easier compared to conventional intragastric laparoscopic technique.