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目的研究单孔无气腹悬吊式腹腔镜在妇科手术中的安全性和可行性。方法将2011年5～10月在我院妇科的20例单孔无气腹悬吊式腹腔镜手术与同期40例传统腹腔镜手术进行比较。单孔无气腹悬吊式腹腔镜用骨科克氏针克氏钢针从耻骨联合上约4cm处穿入腹壁皮肤,向上沿腹白线皮下潜行4～5cm,至脐下2cm处穿出腹壁皮肤,或下腹部横穿皮下(间径约10cm),克氏针两端固定后用吊链挂在悬吊棒横杆上,形成腹腔镜手术空间代替CO2气腹。观察手术时间、术中出血量、术后并发症及术后恢复情况等。结果两组手术均顺利完成,无1例中转开腹。单孔无气腹组手术时间(25.3±8.1)分钟短于传统腹腔镜组(36.3±10.2)分钟,差异有显著性(P<0.05);单孔无气腹组术中出血量(38.6±12.5)mL与传统腹腔镜组(36.1±11.3)mL比较差异无显著性(P>0.05);单孔无气腹组排气时间(26.7±10.4)小时与传统腹腔镜组(28.9±12.3)小时比较差异无显著性(P>0.05);单孔无气腹组术后并发症明显少于传统腹腔镜组(P<0.05)。结论单孔无气腹悬吊式腹腔镜技术是一种微创手术,将开腹的操作方便与腹腔镜的微创巧妙地结合起来,手术时间缩短,与传统气腹腹腔镜相比,还能避免CO2气腹引起的并发症,而且缝合、打结等操作简单易行,有更高的安全性和可行性,值得推广运用。
Objective To study the safety and feasibility of single hole pneumoperitoneal laparoscopy in gynecological surgery. Methods From May to October in 2011, 20 cases of single-hole pneumoperitoneum-free laparoscopic surgery in our hospital were compared with 40 cases of conventional laparoscopic surgery. Single hole without pneumoperitoneal laparoscopic orthokeratology Kirschner wire needle from the pubic symphysis about 4cm into the abdominal wall skin, up along the belly white line sneak 4 ~ 5cm, 2cm below the umbilical cord out of the abdominal wall The skin, or the lower abdomen across the skin (about 10cm in diameter), Kirschner wire fixed at both ends with a hanging chain hanging rod in the hanging rod to form a laparoscopic surgical space instead of CO2 pneumoperitoneum. Observed the operation time, intraoperative blood loss, postoperative complications and postoperative recovery. Results The two groups of surgery were successfully completed, no case of conversion to laparotomy. The time of operation in the single hole pneumoperitoneum group (25.3 ± 8.1) minutes was shorter than that in the traditional laparoscopic group (36.3 ± 10.2) minutes, the difference was significant (P <0.05) (26.7 ± 10.4) hours in the single-hole pneumoperitoneum group was not significantly different from that in the traditional laparoscopic group (28.9 ± 12.3) (P> 0.05) (P> 0.05). The postoperative complications of single hole without pneumoperitoneum group were significantly less than those of conventional laparoscopic group (P <0.05). Conclusions The single-hole pneumoperitoneum-free laparoscopic technique is a minimally invasive surgery that combines the convenience of laparotomy with the minimally invasive laparoscopy and shortens the operation time. Compared with traditional pneumoperitoneal laparoscopy, CO2 pneumoperitoneum can avoid the complications caused by, and suture, knot and other operations easy, with higher safety and feasibility, it is worth promoting the use of.