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浙江大学学报（医学版）
浙江大学学报（医学版）  2015, Vol. 44 Issue (1): 79-84    DOI: 10.3785/j.issn.1008-9292.2015.01.013
原著     
自制简易单孔器行单孔腹腔镜全腹膜外腹股沟疝修补术
陈其龙, 严加费, 吴迪, 蔡小燕, 潘宇, 金巍巍, 朱一平, 牟一平
浙江大学医学院附属邵逸夫医院普外科 浙江大学微创外科研究所, 浙江 杭州 310016
Single-incision laparoscopic surgery with self-made port for totally extraperitoneal hernioplasty: a report of 7 cases
CHEN Qi-long, YAN Jia-fei, WU Di, CAI Xiao-yan, PAN Yu, JIN Wei-wei, ZHU Yi-ping, MOU Yi-ping
Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine; Minimally invasive Surgery Institute of Zhejiang University, Hangzhou 310016, China
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摘要：

目的:探讨采用自制简易单孔器行单孔腹腔镜全腹膜外腹股沟疝修补术(SILS-TEP术)的安全性和可行性。方法:病例来自2013年2~4月浙江大学医学院附属邵逸夫医院普外科。采用一次性切口牵开固定器、无菌手套和普通腹腔镜套管制成简易单孔器,使用常规腹腔镜器械对7例腹股沟疝患者行SILS-TEP术,总结患者的临床资料和随访结果。结果:全部7例(9侧)腹股沟疝患者均行SILS-TEP术成功,中位手术时间90.0(70～125)min,中位出血量10.0(5.0～20.0)mL,中位住院天数2.0(2.0～4.0)d,术后患者疼痛轻微,无围手术期并发症。随访3个月切口愈合佳,均无复发及其他并发症发生。结论:采用自制简易单孔器行SILS-TEP术初步经验显示安全可行,该方法能简化单孔手术器械,减轻患者经济负担,易于基层医院推广应用。
关键词： 腹膜/外科学;  腹腔镜检查;  疝, 腹股沟/外科学    
Abstract:

Objective: To explore the feasibility of single-incision laparoscopic totally extraperitoneal hernioplasty (SILS-TEP) with self-made port for repairing of inguinal hernia. Methods: SILS-TEP was performed in 7 inguinal hernia patients (9 sides) with conventional laparoscopic instruments and self-made port, which composed of a wound retractor, surgical gloves and 3 ordinary trocars. The clinical data and fellow-up results of 7 cases were retrospectively collected and analyzed. Results: The self-made port was applied for SILS-TEP uneventfully without the need of additional ports in all 7 patients (9 inguinal hernias). The median operating time was 90.0 (70-125) min, intraoperative blood loss was 10.0 (5.0-20.0) mL and postoperative hospital stay was 2.0 (2.0-4.0) d. The median pain scores of visual analog scale (VAS) at 6 h,12 h, 24 h and 14 d were 3(2～4), 2(1～ 2), 1(0～2) and 0(0～1), respectively. There were no intraoperative complications reported, and all patients were satisfied with wound healing. No hernia recurrence was observed during the 3-months of follow-up. Conclusion: Our initial experiences show that SILS-TEP with self-made port is s safe and feasible surgery, which can simplify the procedure with available equipments and reduce the cost, therefore can be applied in grass-root hospitals.
Key words: Peritoneum/surgery    Laparoscopy    Hernia, inguinal/surgery
收稿日期: 2014-06-03 出版日期: 2015-03-25
CLC:  R656  
基金资助:

浙江省教育厅基金资助项目(Y201326835).
通讯作者: 牟一平(1955-),男,博士,主任医师,教授,博士生导师,主要从事腹腔镜外科疝与腹壁外科研究;E-mail: mouyiping@srrsh.com     E-mail: mouyiping@srrsh.com
作者简介: 陈其龙(1979-),男,硕士,副主任医师,从事普外、疝和腹壁外科工作;E-mail: faithchen197904@163.com
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引用本文:

陈其龙, 严加费, 吴迪, 蔡小燕, 潘宇, 金巍巍, 朱一平, 牟一平. 自制简易单孔器行单孔腹腔镜全腹膜外腹股沟疝修补术[J]. 浙江大学学报（医学版）, 2015, 44(1): 79-84.

CHEN Qi-long, YAN Jia-fei, WU Di, CAI Xiao-yan, PAN Yu, JIN Wei-wei, ZHU Yi-ping, MOU Yi-ping. Single-incision laparoscopic surgery with self-made port for totally extraperitoneal hernioplasty: a report of 7 cases. Journal of ZheJiang University(Medical Science), 2015, 44(1): 79-84.

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http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2015.01.013    或    http://www.zjujournals.com/med/CN/Y2015/V44/I1/79

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