摘要
目的近来,人们将单一切口腹腔镜胃减重手术的方法,视为除经自然腔道内镜手术之外的另一种选择。单一切口经脐腹腔镜胃减重手术的优势在于能隐藏手术瘢痕,获得较好的美容效果。然而,由于器械操作空间有限及肝脏牵引困难,此项技术一直受到很大限制,仅被认为适用于简单胃减重手术。本研究中,通过采用特殊技术和操作以期改善手术的安全及有效性,使其应用于更广泛的领域。方法自2008年12月起,我院采用LST装置(liver-suspension tape)及′Ω形脐孔成形术成功开展单一切口经脐胃减重手术。至2009年7月,共完成40例患者45例次手术,包括5例次胆囊切除术,2例胃束缚带放置,6例次胃袖状切除,32例次Roux-en-Y胃转流术(Roux-en-Y gastric bypass,RYGB),记录术后住院天数及并发症情况。结果平均手术时间89.9min,平均术后住院1.15d。无一例发生术中或术后并发症,无死亡病例。所有病人均满意手术的美容效果。结论采用本技术施行单一切口经脐胃减重手术是安全、可行的,有进一步推广应用于更多外科手术的价值。
Background Recently,single-incision laparoscopic surgery has been used to perform bariatric surgery and is considered an alternative to natural-orifice transluminal endoscopic surgery.When this surgery performed via the transumbilical route,the resultant abdominal wound is hidden,and the cosmetic outcome,better.However,because of the small angle of manipulation and difficulty in liver traction,this technique is not used to perform complex bariatric surgery.In this prospective study,we design a procedure and then assessed the safety and effectiveness of our surgical technique.Methods We used our technique,which involves the use of a ＂liver-suspension tape＂ and omega umbilicoplasty,to perform laparoscopic bariatric surgery via the single-incision transumbilical（SITU）approach since Dec 2008.Till July 2009,40 consecutive patients underwent 45 procedures：5 cholecystectomies,2 adjustable gastric band placements,6 sleeve gastrectomies,and 32 Roux-en-Y gastric bypass operations.We records postoperative hospitalization and complications analysis.Results The mean operation time was 89.9 min,and the mean duration of postoperative hospitalization,1.15 day.No deaths occurred.Only two cases developed seroma in umbilical wound.All patients were satisfied with the cosmetic outcomes.Conclusion Our technique can be safely and effectively used to perform SITU laparoscopic bariatric surgery.This technique could be extended to perform other advanced abdominal surgeries besides bariatric surgery.[
出处
《中国微创外科杂志》
CSCD
2009年第12期1069-1071,1073,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
微创外科
减重手术
胃旁路手术
胆囊切除术
单一切口经脐腹腔镜手术
单一切口腹腔镜手术
] Minimally invasive surgery
Bariatric surgery
Gastric bypass
Cholecystectomy
Single-incision transumbilical laparoscopic surgery
Single-incision laparoscopic surgery
