[1]朱江帆,胡海,马颖璋,等.用改良的器械实现腹壁无可见瘢痕的经脐入路腹腔镜胆囊切除术[J].中国微创外科杂志,2009,09(1):56-58.
　Zhu Jiangfan,Hu Hai,Ma Yingzhang,et al.“NonScar” Total Laparoscopic Cholecystectomy through the Transumbilical Approach[J].Chinese Journal of Minimally Invasive Surgery,2009,09(1):56-58.
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用改良的器械实现腹壁无可见瘢痕的经脐入路腹腔镜胆囊切除术()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
09
期数:
2009年1期
页码:
56-58
栏目:
器械改进
出版日期:
2009-08-01

文章信息/Info

Title:
“NonScar” Total Laparoscopic Cholecystectomy through the Transumbilical Approach
作者:
朱江帆; 胡海; 马颖璋; 徐曼珠
同济大学附属东方医院普外科，上海200120
Author(s):
Zhu Jiangfan;  Hu Hai;  Ma Yingzhang;  et al.
Department of General Surgery, East Hospital of Tongji University, Shanghai 200120, China
关键词:
经脐入路内镜手术; 腹腔镜胆囊切除术; 腹壁; 瘢痕
Keywords:
Transumbilical endoscopy; Laparoscopic cholecystectomy; Abdominal wall; Scar
分类号:
R657.4
文献标志码:
B
摘要:
目的探讨应用改进的器械以避免脐周围器械和trocar冲突，实现腹壁完全无可见瘢痕的经脐入路腹腔镜胆囊切除术的可行性。方法研制无末端膨大部分、内径分别为3、5 mm trocar，其最大直径分别为5、8 mm，器械长度较普通腹腔镜器械长5 cm。用上述器械完成10例经脐入路内镜胆囊切除术。结果1例因显露困难，将脐部3 mm trocar置于右上腹，置入抓钳协助牵引完成手术；其余9例均顺利完成手术。手术时间45~110 min，（62±25）min。无术中、术后并发症。术后1周恢复正常工作。除脐部皱褶部位外，腹壁无可见手术瘢痕。术后1~5个月电话随访，病人术后恢复顺利。结论自行研制、改进的器械行经脐入路内镜手术，使脐周围trocar和器械的冲突有所改进，有助于完全经脐完成手术，达到腹壁无可见手术瘢痕的目的。
Abstract:
ObjectiveTo investigate the feasibility of “nonscar” total laparoscopic cholecystectomy trough the transumbilical approach by using modified instruments.MethodsTrocars (5 and 3 mm in diameter respectively) without the proximal seal system on the sleeves were designed for this procedure. The maximum diameters of the trocars were reduced to 8 and 5 mm respectively. The instruments used in this study were 5 cm longer than commercially available instruments. 10 cases of total laparoscopic cholecystectomy were performed by using the tools.ResultsAll the gallbladders were removed successfully without massive bleeding during dissection. A mini port was placed on the right upper abdomen to assist retraction in one case because of technical difficulty. The mean operation time was (62±25) minutes (range, 45 to 110 minutes) in this series. No intra and postoperative complications occurred. All the patients were satisfied with the abdominal cosmetic results. They were discharged in 48 hours after the operation, and then back to work in a week. Followup was available in the patients for 1 to 5 months. None of them showed complication or recurrence during the period.ConclusionsThe interference between trocars and surgical instruments can be partially avoided by using the modified tools. “Nonscar” total laparoscopic cholecystectomy is feasible by using the technique.

参考文献/References:

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更新日期/Last Update: 2014-01-08