Objective To evaluate the feasibility of a novel homemade single-port device for transumbilical laparoendoscopic single-site surgery (LESS) on the upper urinary system. Methods The clinical data of 30 cases of LESS that were performed (24 cases on the left side, and 6 cases on the right side) from January 2010 to May 2011 in our hospital were analyzed retrospectively. The cases included 14 cases of radical nephrectomy, 12 cases of renal cyst resection, 3 cases of non-functional kidney resection and 1 case of adrenal cystectomy. With side-lying position at the healthy side (45° - 60°) , the patients received LESS by a homemade single-port device through a 4- to 6-cm umbilical incision. Laparoscope (30°) , ultrasonic scalpel, and flexible or non-flexible instruments were employed for the operation. Results The procedure was completed in all the 30 cases within 28 to 185 min, without conversion to open surgery. Intraoperative blood loss ranged from 10 to 200 ml, and the hospital stay ranged from 4 to 8 days. Postoperative pathological examination confirmed preoperative diagnosis in all the patients. No hematoma, infection, intestinal obstruction, or incisional hernia occurred in any of the patients. A follow-up for a mean of 21. 4 months was achieved in all the patients (ranged from 12 to 29 months) , no recurrence was detected during the period. Conclusions Because of its cosmetic outcomes, LESS especially suits female patients. We recommend our homemade single-port device to be widely used for its convenience, flexibility, and low cost.%目的 总结自制单孔装置应用于经脐单孔上尿路腹腔镜技术中的经验体会. 方法 2010年1月～2011年5月,应用自制单孔装置行经脐单孔上尿路腹腔镜手术30例.包括肾癌根治性切除术14例,无功能积水肾切除3例,肾囊肿去顶减压12例,肾上腺囊肿切除1例.左侧24例,右侧6例.45.～60.健侧卧位,升高腰桥,于脐旁做4～6 cm切口,依次切开至腹膜,直视下向腹腔内置入自制单孔装置,置入30°腹腔镜、超声刀、普通或可弯曲手术器械操作. 结果 30例手术均顺利完成,无中转开放手术.手术时间28～185 min,出血量10 ～200 ml,住院时间4～8d.病理结果与术前诊断相符.无血肿、感染、肠梗阻、切口疝等并发症.术后随访12 ～29个月,平均21.4月,无复发. 结论 经脐单孔腹腔镜手术适于追求美观的患者,特别是女性使用.我院自制的单孔装置制作方便,经济实用,可根据手术类型灵活调整,在国内值得推广应用.
展开▼
