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中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (02) : 118 -121. doi: 10.3877/cma.j.issn.1674-6899.2019.02.014

所属专题: 经典病例 文献

病例报告

5 mm微切口单孔腹腔镜全子宫切除术初探
陈继明1, 刘俊玲1, 陆冰颖1, 郑亚峰1, 肖惠超1, 陆佳1, 沈化及1, 陆枰1, 蒋云芬1, 施如霞1,()   
  1. 1. 213000 常州,南京医科大学附属常州第二人民医院城妇科
  • 收稿日期:2018-07-15 出版日期:2019-04-30
  • 通信作者: 施如霞

The preliminary experience of 5mm mini-incision laparoendoscopic single-site surgery for hysterectomy

Jiming Chen1, Junling Liu1, Bingying Lu1, Yafeng Zheng1, Huichao Xiao1, jia Lu1, Huaji Shen1, Ping Lu1, Yunfen Jiang1, Ruxia Shi1,()   

  1. 1. Department of Obstetrics and Gynecology, the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University, Changzhou 213000, China
  • Received:2018-07-15 Published:2019-04-30
  • Corresponding author: Ruxia Shi
  • About author:
    Corresponding author: Shi Ruxia, Email:
引用本文:

陈继明, 刘俊玲, 陆冰颖, 郑亚峰, 肖惠超, 陆佳, 沈化及, 陆枰, 蒋云芬, 施如霞. 5 mm微切口单孔腹腔镜全子宫切除术初探[J/OL]. 中华腔镜外科杂志(电子版), 2019, 12(02): 118-121.

Jiming Chen, Junling Liu, Bingying Lu, Yafeng Zheng, Huichao Xiao, jia Lu, Huaji Shen, Ping Lu, Yunfen Jiang, Ruxia Shi. The preliminary experience of 5mm mini-incision laparoendoscopic single-site surgery for hysterectomy[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(02): 118-121.

目的

初步探讨5 mm微切口单孔腹腔镜全子宫切除术的安全性与可行性。

方法

回顾性分析1例接受5 mm微切口单孔腹腔镜全子宫切除术患者的临床资料并进行总结分析。患者为52岁女性,因发现宫腔占位入院,诊刮术后病理提示为子宫内膜复杂性增生过长伴不典型增生,行5 mm微切口单孔腹腔镜全子宫切除术。

结果

手术成功完成,手术总时间155 min,术中未增加其他通道,无中转开腹,术中出血量约50 ml。患者术后1 d即恢复肠蠕动,术后2 d拔除尿管后即恢复排尿功能。脐部切口为Ⅱ/甲愈合,无明显瘢痕。术后病理提示子宫内膜复杂性增生。患者恢复情况良好,对治疗效果十分满意。

结论

在严格把握手术适应证的前提下,5 mm微切口单孔腹腔镜全子宫切除手术应用于部分条件适合的患者可能是安全可行的。

Objective

To investigate the feasibility and safety of laparoscopic single-site hysterectomy with 5 mm mini-incision.

Methods

A retrospective analysis was made to the clinical data of a patient who underwent 5mm mini-incision single-site laparoscopic hysterectomy at the Department of Obstetrics and Gynecology, the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University. The patient was a 52-year-old woman presented with intrauterine space occupying and pathological findings after curettage suggested endometrial complex hyperplasia with atypical hyperplasia. Laparoscopic single-site hysterectomy was performed through a 5 mm mini-incision.

Results

The operation was completed successfully. The total operative time was 155 min. No other port incision or transfer to open procedure was needed and the intra-operative blood loss was 50 ml . Bowel peristalsis and micturition recovered 1 d and 2 d respectively after the operation. No obvious scar was left on the surface of umbilicus. The post-operative pathology result was endometrial complex hyperplasia. The patient recovered well, and was satisfactory with the curative efficacy.

Conclusions

Under the indication range, laparoscopic single-site hysterectomy through 5 mm mini-incision might be safe and feasible for some appropriate patients .

图1 提起脐部经脐纵行切开皮肤取长约5 mm切口
图2 利用40/50外科切口保护套建立手术通道
图3 超声刀下推膀胱
图4 单手5 mm LigaSure处理子宫血管
图5 单手双极电凝处理宫骶韧带
图6 单手单极电凝钩切开阴道
图7 自阴道缝合阴道残端并放置T管
图8 脐孔成形后脐轮形态未破环且切口微小隐匿美观
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