目的探讨腹腔镜手术方法在膀胱疾病中的应用。方法膀胱憩室患者,憩室同侧的输尿管内插入支架管以防损伤,保留导尿管。经腹腔途径于脐部,左、右腹直肌旁分别放置10 mm、5 mm、5mm穿刺套管。先将膀胱充盈,在病变部位剪开腹膜前壁,分离并切除憩室,用2-0可吸收线缝合膀胱壁两层。放入电切镜,切除膀胱颈梗阻或行低压TUR-P。膀胱破裂患者,采取脐部、阑尾切口两端,分别放置10 mm、5 mm、5 mm穿刺套管,先吸尽腹腔内尿液,探查腹腔后,用2-0可吸收线连续缝合膀胱壁两层。结果本组患者手术均成功,手术时间90~120 min,术中出血20~40 ml,术后1~2 d拔除引流管,第7天行膀胱造影无憩室影像,切口愈合好,拔出导尿管,恢复正常排尿。随访时间分别为13~38个月。无复发,排尿正常。结论通过本组患者的疗效观察,笔者认为腹腔镜手术在膀胱疾病的应用是安全、可行的,具有创伤小、恢复快、并发症少等优点。可以同时行其他手术,一次完成膀胱疾病和其他疾病的治疗。 Objective To investigate the application of laparoscopic surgery in bladder disease. Methods Bladder diverticulum patients, diverticula ipsilateral ureter inserted into the stent tube to prevent injury, retaining the catheter. The peritoneal approach was placed in the umbilicus, left and right rectus abdominis were placed 10 mm, 5 mm, 5mm puncture cannula. Bladder filling first cut the peritoneal anterior wall in the lesion, separation and removal of the diverticulum, with 2-0 absorbable suture bladder wall two layers. Into the resectoscope, removal of bladder neck obstruction or line TUR-P. Bladder rupture patients to take umbilical, appendectomy ends, were placed 10 mm, 5 mm, 5 mm puncture cannula, first to absorb intraperitoneal urine, probing the abdominal cavity, with 2-0 absorbable suture continuous bladder wall Two floors. Results All the patients were operated successfully. The operation time was 90 ~ 120 min, the intraoperative bleeding was 20 ~ 40 ml. The drainage tube was removed 1 ~ 2 d after operation. The cystography without diverticulum image was performed on the 7th day. The incision healed well, Urine, normal urination. Follow-up time was 13 to 38 months. No recurrence, normal urination. Conclusion Through the observation of the efficacy of this group of patients, I believe that laparoscopic surgery in the application of bladder disease is safe and feasible, with less trauma, rapid recovery, fewer complications and so on. Other operations can be performed simultaneously to complete the treatment of bladder diseases and other diseases in one go.