自制单口装置在泌尿外科单孔后腹腔镜手术中的应用(附114例报告)

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摘要 目的:探讨自制单口装置行单孔后腹腔镜手术治疗各种泌尿系统疾病的安全性和可行性。方法:使用自制单口装置对114例患者行单孔后腹腔镜泌尿外科手术,包括2个控制环和1个8号无粉外科手套组成一个单孔多通道操作器械,使用常规腹腔镜器械进行后腹腔镜手术。其中60例行根治性肾切除术,15例行根治性肾输尿管全长切除术,19例行肾部分切除术(包括1例同时行对侧肾上腺腺瘤切除术),11例行亲属活体供肾切取术,6例行肾上腺肿瘤切除术(包括1例同时行同侧肾囊肿去顶术),2例行肾囊肿去顶术,1例行输尿管切开取石术。结果:114例患者均经单孔后腹腔镜手术成功,无改行常规腹腔镜手术或开放手术。手术时间40~340 min,平均137.14 min;术中出血5~600 ml,平均63.82 ml;住院时间6~36 d,平均12.71 d。无任何重大手术并发症,所有患者均表示满意。结论:应用自制单口装置行泌尿外科单孔后腹腔镜腔镜手术是安全可行的,费用低,可进一步减轻患者创伤,是一种有广阔应用前景的手术治疗方案。

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	史立新
	祝强
	董隽
	蔡伟
	宋涛
	张磊
	孙圣坤
	祖强
	张旭

关键词 ：单孔腹腔镜, 后腹腔镜, 肾切除, 供肾切取术, 肾部分切除术, 肾上腺肿瘤切除术

Abstract：Objective:To present our initial experience of single-port retroperitoneal laparoscopic urological surgery using the home-made single port access laparoscopic system for urinary system diseases, and verify the safety and feasibility of these surgery.Methods:We performed retroperitoneal laparoendoscopic urological surgery on 114 patients by using the home-made single-port device. The device included two control loops, and a powder-free surgical glove (No. 8) to form a multi-channel operation equipment, putting conventional laparoscopic instruments into the abdominal cavity in surgery. Of these, 60 patients underwent radical nephrectomy, 15 underwent radical resection of renal ureter, 19 underwent partial nephrectomy(including 1 case of contralateral adrenalectomy meanwhile),11 patients living-donor nephroureterectomy, 6 cases of adrenalectomy(including 1 case of unroofing of renal cyst at the side), 2 routine renal cyst surgeries, 1 ureterolithotomy. The age distribution of patients ranged 30 to 79 years, an average of 52 years; male 66, female 48.Results:A total of 114 patients have undergone single-port laparoscopic surgery, no conversion to conventional laparoscopic surgery or open surgery. All cases were completed successfully. The total operative time for the various procedures was137.14 mins (range 40 to 340 mins). The mean blood loss was63.82 ml(range 5 to 600 ml) for the procedures. The hospital stay was 12.71 days (range 6 to 36 days) for the procedures. Without any major complications, all patients were satisfied.Conclusions: It appears to be a feasible and safe surgical strategy to perform retroperitoneal laparoscopic urological surgery using our homemade single-port device with multiple manipulation channels. It is also cost-effective. The patients benefited from this single-port technique because only one skin scar left postoperatively. It is a wide prospective method of urological surgery.

Key words： laparoendoscopic single-site surgery retroperitoneoscopy nephrectomy donor nephrectomy partial nephrectomy adrenalectomy

收稿日期: 2012-11-30

ZTFLH:

R692

通讯作者: 董隽,jdong@medmail.com.cn

引用本文:

史立新, 祝强, 董隽, 蔡伟, 宋涛, 张磊, 孙圣坤, 祖强, 张旭. 自制单口装置在泌尿外科单孔后腹腔镜手术中的应用(附114例报告)[J]. 微创泌尿外科杂志, 2013, 2(1): 19-23.
Shi Lixin, Zhu Qiang, Dong Juan, Cai Wei, Song Tao, Zhang Lei, Sun Shengkun, Zu Qiang, Zhang Xu. Single-site retroperitoneal laparoscopic urological surgery using the home-made single-port device (114 cases). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2013, 2(1): 19-23.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1094.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2013/V2/I1/19

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