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中华妇幼临床医学杂志(电子版) ›› 2020, Vol. 16 ›› Issue (05) : 504 -509. doi: 10.3877/cma.j.issn.1673-5250.2020.05.002

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采用传统腹腔镜器械开展经脐单孔腹腔镜手术技术在妇科手术中的应用现状
唐明鸣1, 李林1, 李征宇1,†()   
  1. 1. 四川大学华西第二医院妇产科、出生缺陷与相关妇儿疾病教育部重点实验室，成都　610041
  • 收稿日期:2020-05-30 修回日期:2020-09-09 出版日期:2020-10-01
  • 通信作者: 李征宇

Current status on application of transumbilical laparoendoscopic single-site surgery using conventional laparoscopic instruments for gynecologic surgery

Mingming Tang1, Lin Li1, Zhengyu Li1,†()   

  1. 1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2020-05-30 Revised:2020-09-09 Published:2020-10-01
  • Corresponding author: Zhengyu Li
  • Supported by:
    Applied Basic Research Program of Science and Technology Department of Sichuan Province(19YYJC2397)
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唐明鸣, 李林, 李征宇. 采用传统腹腔镜器械开展经脐单孔腹腔镜手术技术在妇科手术中的应用现状[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(05): 504-509.

Mingming Tang, Lin Li, Zhengyu Li. Current status on application of transumbilical laparoendoscopic single-site surgery using conventional laparoscopic instruments for gynecologic surgery[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(05): 504-509.

经脐单孔腹腔镜手术(TU-LESS)是目前国际最前沿的妇科微创技术，术中手术器械及设备经脐部进入腹腔，利用患者脐部皮肤皱褶遮挡手术切口。该术式对施术者的手术经验和技巧提出新的挑战。为解决由于器械置入部位集中、相互碰撞及"操作三角"丧失导致的TU-LESS操作困难问题，相继研发TU-LESS专用器械，如加长预弯、可变视角腹腔镜镜头等。这样虽然解决了妇科TU-LESS的手术操作技术难题，但是由于专用器械费用昂贵，多为一次性器械，而限制TU-LESS在基层医院妇科临床的广泛开展。采用传统多孔腹腔镜手术器械开展妇科TU-LESS，具有费用低及操作相对容易等优势，而适于基层医院普及，而且既可节约手术成本，又可达到手术切口美观目的。笔者拟就采用传统腹腔镜器械开展妇科TU-LESS的利弊及其在妇科手术中应用的最新研究现状进行阐述。

关键词: 腹腔镜, 经脐单孔腹腔镜, 传统腹腔镜器械, 妇科外科手术, 女(雌)性

Transumbilical laparoendoscopic single-site surgery (TU-LESS) is currently the most cutting-edge minimally invasive gynecological technology in the world. During the operation, surgical instruments and equipment enter the abdominal cavity through umbilical hole, and the umbilical skinfold is used to block the surgical incision. This operation method poses new challenges to the experience and skills of the operator. To solve problems caused by concentration of instrument placement, mutual collision, and loss of " operating triangle" in TU-LESS, TU-LESS dedicated instruments, such as extended pre-bending, variable visual angle laparoscopic lens and so on have been successively developed. Although these solve the operation problems, its higher price and for one-time use limit the extensive development of TU-LESS in gynecological clinic of primary hospitals. So the use of conventional laparoscopic instruments to develop gynecological TU-LESS arises at the historic moment. The use of conventional multiple-port laparoscopic surgical instruments has the advantages of low price and relatively easy operation, and is suitable for popularization in primary hospitals. Using conventional laparoscopic instruments for gynecological TU-LESS can not only save costs, but also achieve the aesthetic purpose of surgical incisions brought by TU-LESS. The author intends to elaborate on the advantages and disadvantages of TU-LESS using conventional laparoscopic instruments for and its application in gynecologic surgery.

Key words: Laparoscopes, Transumbilical laparoendoscopic single-site surgery, Conventional laparoscopic instruments, Gynecologic surgical procedures, Female
图1 采取传统腹腔镜器械进行TU-LESS的术后手术切口外观
图2 采取传统腹腔镜器械进行TU-LESS的trocar位置
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