Single-port laparoscopic surgery in urology: Initial experience
Single-port laparoscopic surgery in urology: Initial experience
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DOI：
10.1016/j.urology.2007.11.034
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发表时间：
2008-01-01
期刊：
影响因子：
2.1
通讯作者：
Gill, Inderbir S.
中科院分区：
文献类型：
--
作者：
Kaouk, Jihad H.;Haber, George-Pascal;Gill, Inderbir S.
目的：介绍我们使用Uni-X单口接入腹腔镜系统进行单口腹腔镜泌尿外科手术的初步经验，该系统是一种单口、多通道插管，配有专门设计的弯曲腹腔镜器械。方法：我们对10例患者进行了单孔腹腔镜手术，其中4例为肾冷冻治疗，1例为楔形肾活检，1例为根治性肾切除术，4例为腹腔骶colcol固定术。对于经腹膜入路，多通道端口经腹腔插入，对于腹膜后镜检查，端口插入在第12肋的尖端。数据被前瞻性地收集到我们的机构审查委员会批准的数据注册表中。结果自2007年9月25日以来，共有10例患者因各种上腹部和盆腔病理发现接受了单孔腹腔镜手术。所有病例均成功完成，未转为标准腹腔镜入路。各种肾脏手术的总手术时间为2.5小时（范围2至3.2），骶髋固定术的总手术时间为2.5小时（范围2至3）。肾脏手术的平均失血量为100毫升，骶骶固定术的平均失血量为90毫升。肾脏手术的住院时间为2.8天（1 - 8天），骶髋固定术的住院时间为2天。一例并发症发生在基线充血性心力衰竭患者，她接受了细胞消融手术，术后需要氧气面罩通气，延迟了1周出院。同一例患者，术前贫血，输注3u填充红细胞，尽管术后计算机断层扫描显示肾周小血肿。结论单孔腹腔镜肾冷冻治疗、楔形肾活检、根治性肾切除术和腹腔骶colpop固定术是安全可行的。额外的经验和继续调查是必要的。
OBJECTIVES To present our initial experience with single-port laparoscopic urologic surgery using the Uni-X Single Port Access Laparoscopic System, a single port, multichannel cannula, with specially designed curved laparoscopic instrumentation.METHODS We performed single-port laparoscopic surgery in 10 patients, including renal cryotherapy in 4, wedge kidney biopsy in 1, radical nephrectomy in 1, and abdominal sacrocolpopexy in 4. For the transperitoneal approach, the multichannel port was inserted transumbilically, and for retroperitoneoscopy, the port was inserted at the tip of the 12th rib. Data were collected prospectively into our institutional review board-approved data registry.RESULTS Since September 25, 2007, a total of 10 patients have undergone single-port laparoscopic surgery for various upper abdominal and pelvic pathologic findings. All cases were completed successfully, without conversion to a standard laparoscopic approach. The total operative time for the various kidney procedures was 2.5 hours (range 2 to 3.2) and was 2.5 hours (range 2 to 3) for sacrocolpopexy. The mean blood loss was 100 mL for the renal procedures and 90 mL for sacrocolpopexy. The hospital stay was 2.8 days (range 1 to 8) for the kidney procedures and 2 days for sacrocolpopexy. One complication occurred in a patient with baseline congestive heart failure who underwent ctyoablation and required oxygen mask ventilation postoperatively that delayed her hospital discharge for 1 week. The same patient, who was anemic preoperatively, was transfused with 3 U of packed red blood cells, although the postoperative computed tomography scan revealed a small perinephric hematoma.CONCLUSIONS Single-port laparoscopic renal cryotherapy, wedge kidney biopsy, radical nephrectomy, and abdominal sacrocolpopexy are safe and feasible. Additional experience and continued investigation are warranted.