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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2017, Vol. 10 ›› Issue (02): 89 -92. doi: 10.3877/cma.j.issn.1674-6899.2017.02.007

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经脐单孔三通道腹腔镜在普通妇科疾病中的应用
李武 1, 胡仙珍 1, 陈琳琳 1, 谢继平 1, 阮凡 1, 吕雯 1 , †( )   
  1. 1. 310012 杭州，浙江省立同德医院妇科
  • 收稿日期:2017-02-12 出版日期:2017-04-30
  • 通信作者: 吕雯

Application of laparoendoscopic single-site surgery for ordinary gynecological diseases

Wu Li 1, Xianzhen Hu 1, Linlin Chen 1, Jiping Xie 1, Fan Ruan 1, Wen Lyu 1 , †( )   

  1. 1. Department Gynecology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
  • Received:2017-02-12 Published:2017-04-30
  • Corresponding author: Wen Lyu
  • About author:
    Corresponding author: Lyu Wen, Email:
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目的

探讨单孔腹腔镜手术(1aparoendoscopic single-site surgery，LESS)在妇科良性病变手术中应用的可行性。

方法

2015年8月至2016年5月在浙江省立同德医院住院的普通妇科手术患者39例列入研究对象，行单孔三通道腹腔镜手术，观察手术时间、术中出血量、术后疼痛评分、术后血红蛋白水平、术后住院时间等指标。

结果

39例中，35例(89.7%)成功完成手术，3例(7.7%)转普通腹腔镜手术，1例(2.6%)中转开腹手术。手术时间(68.2 ± 28.1)min，术中出血量(16.2 ± 22.2)ml，术后疼痛评分(1.7 ± 0.6)分，术后血红蛋白(17.5 ± 19.8)g/L，住院时间(4.3 ± 2.1)d。39例患者随访3个月，均无切口疝、出血、术后切口感染等并发症。

结论

LESS尚处于起步阶段，手术有一定难度，手术时间延长，仍然是可以接受的。LESS对患者体表创伤更小，安全可行，美容效果佳。

关键词: 单孔腹腔镜手术, 经脐入路, 三通道, 妇科疾病
Objective

To analyze the feasibility, safety, and efficacy of laparoendoscopic single-site surgery(LESS) for ordinary gynecological diseases.

Methods

Retrospectively analyzed 39 patients who underwent LESS in Tongde Hospital of Zhejiang Province from Aug. 2015 to May 2016. The procedures of LESS surgical techniques were described. operative time, amount of bleeding, postoperative pain VAS score, changes of postoperative hemoglobin, time for postoperative hospital stay and et al were recorded.

Results

35 patients (89.7%)were operated successfully without additional trocar and 3 patients (7.7%)required additional trocar, 1 patient (2.6%)was conversed to laparotomy. The average operation time (68.2 ± 28.1)min, intraoperative blood loss (16.2 ± 22.2)ml, postoperative pain VAS score (1.7 ± 0.6), changes of postoperative hemoglobin (17.5 ± 19.8)g/L, time for postoperative hospital stay (4.3 ± 2.1)d, no complications occurred during intraoperative and postoperative time, follow-up of 3 months, no obvious postoperative self-conscious symptom.

Conclusions

LESS is still in its infancy, which has the certain difficulty and operative time is more length, but is still accepted. LESS for ordinary gynecological diseases was a feasible, safe, and effective surgical management in patients.

Key words: Laparoendoscopic single-site surgery, Transumbilical endoscopic surgery, Three Channels, Ordinary gynecological diseases
图1 单孔三通道的外部
图2 腹腔内操作图像
图3 缝合以后的切口
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