摘要
目的：总结应用常规腹腔镜器械行经脐三孔腹腔镜阑尾切除术（laparoscopic appendectomy,LA）的手术经验及体会,探讨其可行性、安全性及实用性。方法：全麻下患者取头低脚高仰卧位,沿脐周皮肤皱褶线画圆,从6点钟方向弧行切开皮肤1 cm,穿刺10 mm Trocar,探查腹腔,决定行经脐腹腔镜手术后,分别于脐2点、11点钟方向穿刺5 mm Trocar,在腹腔镜下完成阑尾切除。结果：20例均顺利完成手术,手术时间30～60 min,术中出血量5～15 ml,术后胃肠功能恢复时间0.5～1.5 d,下床活动时间0.5～1.0 d,无腹腔出血、残端瘘、切口感染等并发症发生。脐部切口均Ⅰ期愈合。术后疼痛轻微,患者均痊愈出院。术后随访,手术瘢痕隐蔽,美容效果明显。结论：常规腹腔镜器械应用于经脐三孔LA安全、可行,费用少,美容效果明显,具有临床实用价值,但对术者的操作水平要求较高。
Objective：To summarize the experiences of applying routine laparoseopic appliance in three-port transumbilical laparoscopic appendectomy, and explore the feasibility, security and practicality of this surgical technique. Methods ： After general anes- thesia, the patient lied at supine position with the head lower and legs higher. After making 1 cm curved incision around the umbilicus （start from 6 o＇clock） , a 10 mm Trocar was introduced to observe the abdominal cavity, afterwards,if laparoscopy was determined, two operational Trocars （5 mm） were placed at 2 o＇ clock and 11 o＇ clock respectively to remove the appendix. Results：The 20 cases of laparoscopy were successfully completed, the operation time was 30-60 min, amount of the intraoperative hemorrhage was 5-15 ml, post- operative gastrointestinal function recovery time was 0.5-1.5 d and the ambulation time was 0.5-1.0 d. No complication was found, such as postoperative hemorrhage, stump fistula, infection of incision and so on. The umbilical incisions all healed by first intention. Patients ached slightly after operation and all recovered well. Follow-up showed that the scar was hidden and the cosmetic effect was promising. Conclusions：Applying routine laparoseopic appliance in three-port transumbilical laparoscopic appendectomy is safe and feasible, costs less, has clinical application value, and its cosmetic outcomes are satisfying, but the operator must have great skill.
出处
《腹腔镜外科杂志》
2015年第4期305-307,共3页
Journal of Laparoscopic Surgery
关键词
阑尾切除术
腹腔镜检查
经脐
常规器械
Appendectomy
Laparoscopy
Transumbilicus
Ordinary instruments
作者简介
戚鹏（1977-）男，湖北省中山医院普通外科副主任医师，主要从事肝胆外科的研究。
通讯作者：罗金波，E-mail：1wmysh88@163．com
