摘要
目的推介一种简单易行的后腹腔镜输尿管切开取石中双J管置入方法。方法利用膀胱镜逆行插管原理,在后腹腔镜输尿管切开取石术中,经10mmTrocar膀胱镜引导下置入带超滑导丝双J管,在监视器下合理运用膀胱镜远端转向杠杆,使双J管头端对准输尿管切口缓慢送入输尿管下端,抽出导丝,换两把分离钳将双J管尾端置入输尿管上段。结果采用此方法在后腹腔镜输尿管切开取石术中放置双J管共36例,平均置管时间4min,平均手术时间60min,均顺利完成手术。结论后腹腔镜输尿管切开取石术是一种安全有效的微创技术,但术中双J管置入是手术难点之一。经10mmTrocar膀胱镜引导下置入双J管操作更方便,耗时明显减少,也便于训练及推广。
【Objective】To introduce a simpler and easier technique of inserting D-J tubes in retroperitoneal laparoscopic ureterolithotomy （RLU）.【Methods】Access of retrograde ureteral catheter with cystoscope,in RLU, the stiff type guide wire was put through the end of D-J tube in advance, the proximal end of the slent was put down to the distal end of ureteral incision until the bladder （maintaining whole length of guide wire and connection promoting rod in vitro）, and then continuously downward to near ureteral incision with the remaining 1 cm from incision ,in vitro removing built-in guide wire and operating to disconnect the promoting rod from the slent, the proximal end of D-J tube was drew up along the ureteral lumen with two elastic separating pliers until the pelvis.【Results】36 patients suffered from impacted upper ureteric calculi were operated by RLU between Mar.2008 and Mar. 2011. The mean D-J tubes implantation time was 4min, the mean operation time was 60min. The operation was successfully performed in all cases.【Conclusions】 As a kind of micro-insult operation for upperureteric calculi. RLU is very safe and effective. But it＇s hard to insert D-J tubes in surgery. Our method is more convenient and less time consuming obviously, and is convenient for training and promoting.
出处
《中国内镜杂志》
CSCD
北大核心
2013年第6期618-620,共3页
China Journal of Endoscopy
关键词
后腹腔镜
输尿管切开取石术
膀胱镜
超滑导丝
retroperitoneal laparoscopic
ureterolithotomy
cystoscope
stiff type guide wire
