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目的:探讨应用单孔三通道后腹腔镜技术完成肾切除术的可行性。方法:应用单孔三通道后腹腔镜技术对2例成人无功能肾患者施行肾切除术。腋后线肋缘下作3 cm切口,扩张腹膜后间隙。置入自制的单孔三通道穿刺器,腹腔镜通道为5 mm,另外两个操作通道分别为12 mm和5 mm。手术操作通过前端可弯曲的手术钳、手术剪和超声刀、吸引器完成。结果:2例手术均取得成功。手术时间分别为156 min和174 min;出血量为100 ml和150 ml;术后住院时间均为7天。患者腰部仅留一3 cm大小的手术瘢痕。未发生术中术后并发症。结论:基于胚胎性自然腔道手术(E-NOTES)理论,我们验证了在单孔腹腔镜下建立后腹腔空间及完成肾脏手术的可行性。随着技术和设备的改进,该技术可望为患者提供有效的治疗选择。
Objective: To investigate the feasibility of using single-hole, three-channel laparoscopy to perform nephrectomy. Methods: Nephrectomy was performed on 2 cases of non-functional renal failure in adults using single-hole three-channel retroperitoneal laparoscopy. Axillary line under the axillary margin 3 cm incision, dilatation of retroperitoneal space. A homemade one-port three-channel trocar was inserted. The laparoscopic access was 5 mm and the other two access channels were 12 mm and 5 mm, respectively. Surgical operation through the front of flexible surgical forceps, scissors and scalpel knife, suction device to complete. Results: Two surgeries were successful. The operation time was 156 min and 174 min respectively. The bleeding volume was 100 ml and 150 ml. The postoperative hospital stay was 7 days. Only a 3 cm surgical scar was left in the patient’s waist. No intraoperative and postoperative complications occurred. CONCLUSION: Based on the E-NOTES theory, we validated the feasibility of establishing a posterior abdominal space and completing a kidney surgery under single-hole laparoscopy. As technology and equipment improve, this technology is expected to provide patients with an effective treatment option.