摘要
目的初步探讨采用单孔三通道法行腹腔镜下输卵管切除术的可行性与安全性。方法回顾性分析2015年8月至10月陕西省西安市阎良区人民医院妇产科采用三通道法联合常规腹腔镜手术器械行单孔腹腔镜输卵管切除手术的2例异位妊娠患者的临床资料。其中1例患者行左侧输卵管切除术＋盆腔粘连松解术,1例行右侧输卵管切除术＋盆腔粘连松解术。经脐孔上缘行半环形切口长约2.0 cm,采用单孔三通道法进行穿刺,置入腹腔镜和操作钳实施手术。结果 2例手术均获得成功,术中未增加其他通道,无中转开腹。2例患者手术时间20~30 min,术中出血5~10 ml,术后1 d体温36.6~37.1℃,肛门排气时间1.0~1.5 d。2例患者术后复查血绒毛膜促性腺激素下降满意,腹部无明显外观伤口,患者术后住院3~5 d出院,术后无持续性异位妊娠、脐疝、出血、感染等并发症发生。结论选择合适的病例,采用单孔三通道法联合常规腔镜器械行腹腔镜输卵管切除手术是一种安全可行、微创而美容的手术。
Objective To investigate the feasibility and safety of laparoendoscopic surgery （LESS） in salpingectomy by three-channel single port through a trans-umbilical access. Methods A retrospective analysis was performed of 2 patients enrolled from Aug. to Oct. 2015 who underwent unilateral salpingectomy through LESS procedure by three-channel single port combined with the traditional laparoscopic instruments. Clinic data were collected from 2 patients, 1 patient underwent left fallopian tube resection and pelvic adhesion lysis, the other accepted right fallopian tube resection and pelvic adhesion lysis. LESS was performed by using a single port with triple-channel inserted method through a solitary 2.0 cm upper umbilicus incision. Results Both the 2 patients had LESS surgery successfully. No other port incision or transfer to open procedure was needed. The actual operative time was 20-30 minutes. The intra-operative blood loss was 5-10 ml. The temperature on 1st day after operation was 36.6-37. 1℃. The first post- operative flatus time was 1. 0-1. 5 days. The post-operative HCG results of the two patients decreased remarkably. The operation incision scars of the two patients were not obvious. The patients were discharged within 3-5 days after procedure without complications such as persistent ectopic pregnancy, umbilical hernia, hemorrhage, and infection. Conclusions With the precondition of strict indication, LESS using single port with triple-channel inserted method can be a promisingly safe, minimally invasive and cosmetic approach to salpingectomy.
出处
《中华腔镜外科杂志（电子版）》
2015年第6期57-59,共3页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
常州青年医学创新人才工程项目[常卫科教(2010)368号]
常州市卫生局青年科技人才项目(QN201406)
关键词
单孔三通道法
单孔腹腔镜手术
经脐
输卵管切除术
异位妊娠
Three-channel single port
Laparoendoscopic single-site surgery
Trans-umbilical
Salpingectomy
Ectopic pregnancy
