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目的尝试经脐单孔多通道腹腔镜下肾部分切除术,总结应用体会和手术难点。方法 2009年8月至9月对2例患者施行单孔多通道腹腔镜下肾部分切除术,均为右肾,总结手术经验和难点。结果 2例手术均顺利完成,术中增加1个5mm辅助通道以牵开肝脏。手术时间分别为255、240min,肾动脉阻断时间分别是48、40min,出血量分别为100、50ml,术中术后均未输血,未使用镇痛剂,分别于术后9、5d拔除引流管,术后住院天数分别为13、12d。结论单孔多通道腹腔镜下肾部分切除技术可行、手术安全,且瘢痕小而隐蔽,美容效果好;但临床开展需要特殊的手术器械,缝合打结操作有一定难度;右侧肾脏手术常需要辅助通道牵拉肝脏以获得良好的显露效果。
Objective To try to transrectal partial laparoscopic transabdominal partial hysterectomy via umbilical umbilical single hole to summarize the application experience and surgical difficulties. Methods From August 2009 to September 2009, 2 patients underwent single-hole multi-channel laparoscopic partial nephrectomy, all of which were right kidney. The experience and difficulties of operation were summarized. Results 2 cases of surgery were successfully completed, surgery to increase a 5mm auxiliary channel to retract the liver. The operation time was 255 and 240 min, the renal artery occlusion time was 48 and 40 min, the bleeding volume was 100 and 50 ml respectively. No blood transfusion was given during operation and no analgesic was used. Drainage was performed 9 and 5 days after operation Tube, postoperative hospital days were 13,12 d. Conclusion The single-hole multi-channel laparoscopic partial nephrectomy is feasible and safe, and the scars are small and concealed, so the cosmetic effect is good. However, it is difficult to perform special surgical instruments and suture knots in clinic. Right kidney surgery often requires Auxiliary channels pull the liver for good exposure.