[1]孔伟 熊光武*① 郭鹏② 夏新宇 黄山 李雪 王静波 徐惠成*.经脐孔取瘤法在多孔腹腔镜子宫肌瘤剔除术中的应用[J].中国微创外科杂志,2021,01(6):563-565.
　Kong Wei*,Xiong Guangwu,Guo Peng,et al.Application of Transumbilical Paring & Retrieving Technique in Conventional Laparoscopic Myomectomy[J].Chinese Journal of Minimally Invasive Surgery,2021,01(6):563-565.
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经脐孔取瘤法在多孔腹腔镜子宫肌瘤剔除术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年6期
页码:
563-565
栏目:
经验交流
出版日期:
2021-06-25

文章信息/Info

Title:
Application of Transumbilical Paring & Retrieving Technique in Conventional Laparoscopic Myomectomy
作者:
孔伟 熊光武*① 郭鹏② 夏新宇 黄山 李雪 王静波 徐惠成*
（贵黔国际总医院妇产科，贵阳550018）
Author(s):
Kong Wei*;  Xiong Guangwu;  Guo Peng;  et al.
*Department of Obstetrics and Gynecology, Guiqian International General Hospital, Guiyang 550018，China
关键词:
脐孔; 腹腔镜; 子宫肌瘤; 肌瘤剔除术
Keywords:
Umbilical incision; Laparoscopy; Leiomyoma; Myomectomy
文献标志码:
B
摘要:
目的探讨多孔腹腔镜子宫肌瘤剔除术经脐孔取标本的安全性和有效性。方法借鉴单孔腹腔镜脐部切口的建立和修复技术，2020年7月~2021年1月我们在23例腹腔镜子宫肌瘤剔除术中，采用经脐孔取瘤法取出标本。手术步骤包括常规的瘤体剔除,子宫缝合,经脐孔置入普通标本袋,袋装标本,延长脐部穿刺孔,直视下经脐孔钳夹、牵拉、缩减取出标本袋内的瘤体以及切口修复。结果23例手术均顺利完成。剔除肌瘤平均2.6枚（1~8枚）。术中自置入标本袋开始计时，至完成脐孔修复平均14.3 min（8~35 min）。取出瘤体重量平均206.3 g（50~800 g）。术后1 d疼痛视觉模拟评分（Visual Analogue Scale, VAS)平均2.4分（1~4分）。术后病理均为子宫平滑肌瘤。术后电话随访20例，平均随访4.1月（1~6个月），脐部切口愈合良好，无脐部不适。结论经脐孔取瘤法安全、快速、经济,容易学习。
Abstract:
ObjectiveTo investigate the safety and effectiveness of transumbilical paring & retrieving technique in conventional laparoscopic surgery.MethodsBetween July 2020 and January 2021, referring to the establishment and repair technology of transumbilical laparoendoscopic singlesite surgery (TULESS), transumbilical paring & retrieving technique was applied in 23 cases of conventional laparoscopic myomectomy. The operation procedures included ordinary laparoscopic myomectomy and uterine suture, placing the endoscopic bag, bagging specimen, extending the umbilical incision, paring and retrieving specimen and suturing the umbilical incision. Under direct vision, the tumor in the specimen bag was removed by clamping, pulling and reducing through the umbilical incision.ResultsAll the operations were completed successfully. The average number of fibroids removed was 2.6 (range, 1-8). The mean total time of specimen removal process was 14.3 min (range, 8-35 min). The mean specimen weight was 206.3 g (range, 50-800 g). The mean Visual Analogue Scale (VAS) valuated 1 day postoperatively was 2.4 points (range, 1-4 points). Most pathology revealed benign leiomyoma. A total of 20 cases were followed up by telephone, and the average followup time was 4.1 months (range, 1-6 months). The umbilical incisions healed well, and there were no complaints of umbilical discomfort. ConclusionTransumbilical paring & retrieving technique is safe, timesaving, costefficient, and easy to learn.

参考文献/References:

[1]Aksoy H, Aydin T, Ozdamar O, et al. Successful use of laparoscopic myomectomy to remove a giant uterine myoma: a case report. J Med Case Rep,2015,9:286.
[2]孙雪洁，韩璐.腹腔镜子宫肌瘤剔除术后寄生性平滑肌瘤2例报告并文献复习.中国微创外科杂志,2018,18(10):955-957.
[3]郎景和，张国楠，向阳，等.实施腹腔镜下子宫（肌瘤）分碎术的中国专家共识.中国实用妇科与产科杂志,2020,36(7):626-632.
[4]Halaska MJ, Haidopoulos D, Guyon F, et al. European Society of Gynecological Oncology Statement on fibroid and uterine morcellation. Int J Gynecol Cancer,2017,27(1):189-192.
[5]王晓樱,李妍.改良经脐单孔腹腔镜子宫肌瘤剔除术.中国微创外科杂志,2019,19(10):919-921.
[6]刘高焰，马卿莲，刘鹏.经阴道“削苹果”式取标本在腹腔镜巨大子宫全切术中的应用.医学临床研究,2015,32(9):1739-1741.
[7]万学红，卢学峰，主编.诊断学.北京:人民卫生出版社,2013.181.
[8]Moon HS, Jeong K, Lee SR. Roboticassisted single incision myomectomy in large myoma cases. Clin Exp Obstet Gynecol,2017,44(2):283-287.
[9]Peker N, Gundogan S, Sendag F. Laparoscopic management of huge myoma nascendi. J Minim Invasive Gynecol,2017,24(3):347-348.
[10]Song JY. Laparoscopic resection of a rare, large broad ligament myoma. J Minimally Invasive Gynecol,2015,22(4):530-531.
[11]Park JY, Kim TJ, Kang HJ, et al. Laparoendoscopic single site (LESS) surgery in benign gynecology: perioperative and late complications of 515 cases. Eur J Obstet Gynecol Reprod Biol,2013,167(2):215-218.
[12]马迎春,Xiaoming Guan.机器人单孔腹腔镜手术在妇科领域中的应用.妇产与遗传（电子版）,2015,5(3):44-47.
[13]高京海,金志军,李俊平,等.机器人辅助经脐单孔腹腔镜治疗子宫颈浸润癌12例临床分析.实用妇产科杂志,2019,35(10):797-800.
[14]吕小慧,郭欣,李佳,等.机器人单孔腹腔镜在妇科手术中的初步应用探讨.中华腔镜外科杂志(电子版),2019,12(3):154-158.
[15]Zhang Y, Kohn JR, Guan X. Singleincision hysterectomy outcomes with and without robotic assistance. JSLS,2019,23(4):e2019.00046.

备注/Memo

备注/Memo:
*通讯作者，Email：xionggw@163.com（熊光武）；xuhuicheng1970@foxmail.com（徐惠成）①（北京大学国际医院妇产科，北京102206）②（贵州省安顺市人民医院妇产科，安顺561000）
更新日期/Last Update: 2021-08-27