2mm无鞘针形器械在隐瘢痕腹腔镜胆囊切除术中的应用:一种无瘢痕手术新思路

目的:探讨隐瘢痕腹腔镜胆囊切除术的手术方法及应用价值。方法:选择2011年1月至2011年6月60例无严重胆囊炎症的胆囊息肉或胆囊结石患者,随机分为2组,新方法组行隐瘢痕腹腔镜胆囊切除术,单孔组行常规单孔腹腔镜胆囊切除术,对比分析两组患者手术时间、术后切口疼痛程度、术后切口满意程度及中转率。结果:新方法组均顺利完成手术;单孔组28例顺利完成手术,2例中转常规腹腔镜胆囊切除术。新方法组与单孔组手术时间平均(14.17±3.51)min和(24.67±4.12)min,新方法组明显优于单孔组(P<0.01);术后切口疼痛程度轻于单孔组,但差异无统计学意义(P>0.05);术后患者对切口满意程度优于单孔组,差异有统计学意义(P<0.01)。两组均无出血、胆漏、胆管损伤等并发症发生。结论:隐瘢痕腹腔镜胆囊切除术安全、可行,术后瘢痕不明显且隐蔽,相对单孔腹腔镜胆囊切除术,手术时间缩短,手术难度及中转率降低,术后患者切口满意度高,为腹腔镜手术的更微创化发展提供了新的可行途径及思路。

A new scar hidden laparoscopic cholecystectomy using 2 mm instruments without Trocar

Objective:To introduce a new laparoscopic cholecystectomy and compare it with single incision laparoscopic cholecystectomy.Methods:From Jan.2011 to Jun.2011,30 consecutive patients who underwent a new scar hidden laparoscopic cholecystectomy(NLC group) were compared with a prospective cohort of 30 patients who underwent single incision laparoscopic cholecystectomy(SILC group) during the same period.The operation time,pain score,satisfactory score and conversion rate were recorded.Results:All operations were performed successfully in NLC group.Two patients were converted to conventional 3-port laparoscopic cholecystectomy in the SILC group.No post-operative complications occurred in both groups.The operation time was significantly less in the NLC group (14.17±3.51) min] vs.(24.67±4.12) min in SILC group(P<0.01).As to satisfactory score,NLC group was superior to SILC group (4.53±0.57) in NLC group vs.(4.07±0.52) in SILC group,P<0.01].There was also a lower postoperative pain score in the NLC group although the results did not reach statistical significance.Conclusions:The new scar hidden laparoscopic cholecystectomy is a safe and feasible operation.Compared with single incision laparoscopic cholecystectomy,it has a less operation time,less difficulty and conversion rate,but a higher satisfactory score.It demonstrates a new approach for minimally invasive surgery.