针式组合式器械在新式单孔腹腔镜胆囊切除术中的应用

doi:10.3877/cma.j.issn.1674-6899.2018.05.012

中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (05): 310 -312. doi: 10.3877/cma.j.issn.1674-6899.2018.05.012

所属专题：文献资源库；

针式组合式器械在新式单孔腹腔镜胆囊切除术中的应用

田明国 ¹ ^, ^†(

), 贾东 ¹, 杨海涛 ², 刘明奇 ¹, 杨勇 ¹, 范雄伟 ²

^1. 750002 银川，宁夏自治区人民医院肝胆外科
^2. 751000 吴忠，宁夏吴忠市人民医院微创外科

收稿日期:2018-06-16 出版日期:2018-10-30
通信作者: 田明国

Using the assembled needle instruments for the novel single incision laparoscopic cholecystectomy

Mingguo Tian ¹ ^, ^†( ), Dong Jia ¹, Haitao Yang ², Mingqi Liu ¹, Yong Yang ¹, Xiongwei Fan ²

^1. Department of Hepatobiliary Surgery, the People′s Hospital of Ning Xia Autonomous Region, Yinchuan 750002, China
^2. Department of Minimally Invasive Surgery, the People′s Hospital of Wu Zhong City, Wuzhong 751000, China

Received:2018-06-16 Published:2018-10-30
Corresponding author: Mingguo Tian
About author:
Corresponding author: Tian Mingguo, Email: tian88@hotmail.com

全文 ( ) 下载PDF ( )

目的

总结针式组合式器械在新式单孔腹腔镜胆囊切除术(laparoscopic cholecystectomy，LC)中的应用效果。

方法

回顾性分析接受新式单孔LC治疗的24例患者资料。术中将显露器针杆从右肋缘下锁骨中线穿刺进入腹腔，在腹腔内与操作头连接后向上牵引胆囊底浆膜层进行显露。将电钩针杆经剑突下穿刺进入腹腔，在腹腔内与操作头连接后进行胆囊三角分离及剥离胆囊。

结果

开展24例新式单孔LC，其中需要增为2孔者3例，增孔率12.5%；无中转开腹。顺利完成21例(87.5%)新式单孔LC，手术时间(55.2±21.5)min，术中出血量(6.4±12.3)ml，无胆漏、出血、胆管损伤等并发症。

结论

针式组合式显露器和针式组合式电钩结合使用可顺利完成新式单孔LC。

关键词: 针式组合式器械, 单孔腹腔镜胆囊切除术

Objective

To summarize the effect of the assembled needle instruments(ANIs)used in the novel single incision laparoscopic cholecystectomy(SILC).

Methods

The data of 24 cases who had accepted the novel SILC with ANIs were retrospectively studied. Both the manipulating poles of the assembled needle exposing hook and the assembled needle electric coagulating hook were directly inserted to the peritoneal cavity at mid-clavicle line subcostally and sub-xiphoid process. After connecting with the hook heads inside, the gallbladder fundus serosa was retracted and the gallbladder was dissected by electric hook.

Results

In 24 cases performed with SILC, 3 cases required adding another port with adding port rate of 12.5%. There was no conversion to open surgery. The novel SILC was accomplished in 21 cases(87.5%) with operative time of(55.2±21.5)min and operative bleeding of(6.4±12.3)ml. Postoperative complications such as bile leak, bleeding and bile duct injury did not occur.

Conclusions

Combination of the assembled needle exposing hook and assembled needle electric coagulating hook can make the novel SILC with ease.

Key words: Assembled needle instruments, SILC

图1 针式组合式显露器(上)和针式组合式电钩(下)

图2 针式组合式器械在新式单孔腹腔镜胆囊切除术中的应用

图3 新式单孔腹腔镜胆囊切除术的腹部瘢痕效果

1	Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy[J]. Br J Surg, 1997，84(5):695-697.
2	蒋泽生，程远，徐小平．吊线法与三器械法单孔腹腔镜胆囊切除术比较[J]．中华医学杂志，2013，93(6):455-458.
3	Hirano Y, Watanabe T, Uchida T，et al. Single-incision laparoscopic cholecystectomy: single institution experience and literature review[J]．World J Gastroenterol, 2010, 14,16(2): 270-274.
4	李强，王建华．自制立体牵引装置在单孔腹腔镜胆囊切除中的应用[J/CD]．中华腔镜外科杂志(电子版)，2012，5(2):50-52.
5	Shussman N, Schlager A, Elazary R，et al. Single-incision laparoscopic cholecystectomy: lessons learned for success[J]．Surg Endosc，2011, 25(2): 404-407.
6	Dominguez G, Durand L, De Rosa J，et al. Retraction and triangulation with neodymium magnetic forceps for single-port laparoscopic cholecystectomy[J]．Surg Endosc，2009，23(7):1660-1666.
7	李强，王建华，赵占红．磁性牵引装置在小型家猪单孔腹腔镜胆囊切除术中的应用[J]. 山东医药，2016, 56 (1):40-41.
8	Yin H, Wang Z, Xu J，et al. A specific instrument to facilitate single-incision laparoscopic cholecystectomy：an initial experience[J]. Surg Innov, 2011，18(3):289-293.
9	Dapri G, Casali L, Bruyns J，et al. Single-access laparoscopic surgery using new curved reusable instru-ments: initial hundred patients[J]. Surg Technol Int, 2010，20(10):21-35.
10	田明国．胆囊底缝线牵引两孔免夹法腹腔镜胆囊切除术的操作体会[J]．腹腔镜外科杂志，2006，21(9)685-687.
11	Tian MG, ZhangPJ, YangY, et al. Two-port laparoscopic cholecystectomy using a puncturing exposure stick: a more practical approach[J]．Journal of Minimally Invasive Surgery，2013，9(3):122-125.
12	韩金岩，吴硕东，田雨．完全经脐单孔腹腔镜胆囊切除术30例临床应用分析[J/CD]．中华腔镜外科杂志(电子版), 2009，2 (1):28-34.
13	Sodergren M, McGregor C, Farne HA, al. A randomised comparative study evaluating learning curve of novices in a basic single-incision laparoscopic surgerytask[J]. J Gastrointest Surg，2013，17(3):567-575.
14	Sinha R. Transumbilical single-incision laparoscopic cholecys-tectomy with conventional instruments and ports: the way forward[J]. J Laparoendosc Adv Surg Tech A, 2011，21(6):497-503.
15	Garcia-Henriquez N, Shah SR, Kane TD. Single-incision lapa-roscopic cholecystectomy in children using standard straight instruments: a surgeon′s early experience[J]. J Laparoendosc Adv Surg Tech A, 2011，21(6):555-559.
16	Cantore F, Colombo EM, Giuseppe MD，et al. Single access cholecystectomy using standard laparoscopic instruments[J]. Updates Surg，2011，63(1):31-34.
17	吴硕东．经脐单孔腹腔镜胆囊切除术的手术技巧与要点[J]. 腹腔镜外科杂志，2013, 18(3): 161-162.
18	李建平．应用直形器械经脐单孔腹腔镜胆囊切除术[J]．中华肝胆外科杂志，2011，17(3):268-269.

No related articles found!

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Using the assembled needle instruments for the novel single incision laparoscopic cholecystectomy

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Using the assembled needle instruments for the novel single incision laparoscopic cholecystectomy