Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2020, Vol. 16 ›› Issue (05): 504 -509. doi: 10.3877/cma.j.issn.1673-5250.2020.05.002

Special Issue:

Forum

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)

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.

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
[1]
中华医学会妇产科学分会妇科内镜学组. 妇科腹腔镜诊治规范[J]. 中华妇产科杂志,2012, 47(9): 716-718. DOI: 10.3760/cma.j.issn.0529-567x.2012.09.022.
[2]
Wheeless CR. A rapid, inexpensive, and effective method of surgical sterilization by laparoscopy[J]. J Reprod Med, 1969, 3(5): 65-69. DOI: 10.1227/00006123-198005000-00006.
[3]
Langebrekke A, Qvigstad E. Total laparoscopic hysterectomy with single-port access without vaginal surgery[J]. J Minim Invasive Gynecol, 2009, 16(5): 609-611. DOI: 10.1016/j.jmig.2009.06.003.
[4]
顾强,汪意青. 常规器械经脐单孔腹腔镜与传统腹腔镜胆囊切除术的疗效比较[J]. 中国现代普通外科进展,2015, 18(11): 894-896. DOI: 10.3969/j.issn.1009-9905.2015.11.017.
[5]
贾元吉,张凤坤,裴丽峰. 常规腹腔镜器械在经脐单孔腹腔镜结直肠手术中的应用[J]. 中国医疗器械信息,2017, 23(6): 54-55. DOI: 10.3969/j.issn.1006-6586.2017.06.025.
[6]
曹金敏,陈国栋,张伟,等. 常规器械经脐单孔腹腔镜联合胃镜行胃间质瘤切除术1例[J]. 中南医学科学杂志,2014, 42(6): 631-632, 637. DOI: 10.3969/j.issn.2095-1116.2014.06.027.
[7]
贺更生,陈国栋,张伟. 常规器械经脐单孔腹腔镜技术在腹部手术中的应用[J]. 腹腔镜外科杂志,2015, 20(8): 598-601. DOI: 10.13499/j.cnki.fqjwkzz.2015.08.598.
[8]
施晓君,金秀凤,陆松春. 常规器械经脐单孔腹腔镜输卵管切除术41例分析[J]. 中国实用妇科与产科杂志,2014, 30(7): 561-564. DOI: 10.7504/fk2014060120.
[9]
Gou JH, Li ZY, Nie D. et al. Single-incision laparoscopic hysterectomy using conventional laparoscopic instruments: initial experience with 25 cases[J]. Arch Gynecol Obstet, 2018, 298(5): 921-926. DOI: 10.1007/s00404-018-4858-6.
[10]
杨田如,石舟红,贾月改,等. 常规器械经脐单孔腹腔镜与多孔腹腔镜全子宫切除术的比较研究[J].世界最新医学信息文摘,2017, 17(57): 1-3. DOI: 10.19613/j.cnki.1671-3141.2017.57.001.
[11]
Phongnarisorn C, Chinthakanan O. Transumbilical single-incision laparoscopic hysterectomy with conventional laparoscopic instruments in patients with symptomatic leiomyoma and/or adenomyosis[J]. Arch Gynecol Obstet, 2011, 284(4): 893-900. DOI: 10.1007/s00404-010-1770-0.
[12]
Puntambekar S, Rayate N, Nadkarni A, et al. Single-incision total laparoscopic hysterectomy with conventional laparoscopy ports[J]. Int J Gynecol Obstet, 2012, 117(1): 37-39. DOI: 10.1016/j.ijgo.2011.11.021.
[13]
Jung YW, Kim YT, Lee DW, et al. The feasibility of scarless single-port transumbilical total laparoscopic hysterectomy: initial clinical experience[J]. Surg Endosc, 2010, 24(7): 1686-1692. DOI: 10.1007/s00464-009-0830-7.
[14]
Huang CY, Wu KY, Su H, et al. Accessibility and surgical outcomes of transumbilical single-port laparoscopy using straight instruments for hysterectomy in difficult conditions[J]. Taiwan J Obstet Gynecol, 2014, 53(4): 471-475. DOI: 10.1016/j.tjog.2014.08.002.
[15]
Puntambekar SP. Single site laparoscopic radical hysterectomy using conventional ports and instruments[J]. J Minim Invasive Gynecol, 2014, 21(4): 539. DOI: 10.1016/j.jmig.2014.01.013.
[16]
Salamah K, Abuzaid M, Abu-Zaid A. Single-incision laparoscopic surgery in gynecologic surgery: a single-institutional experience from Saudi Arabia[J]. F1000Res, 2017, 6: 1657. DOI: 10.12688/f1000research.12545.1.
[17]
蒋镌,毛世琴,孙瑞芳,等. 常规器械经脐部微孔腹腔镜技术在妇科手术中的应用[J]. 中国实用医药,2018, 13(27): 66-67. DOI: 10.14163/j.cnki.11-5547/r.2018.27.035.
[18]
Fagotti A, Fanfani F, Marocco F, et al. Laparoendoscopic single-site surgery (LESS) for ovarian cyst enucleation: report of first 3 cases[J]. Fertil Steril, 2009, 92(3): 1168.e13-1168.e16. DOI: 10.1016/j.fertnstert.2009.05.060.
[19]
Yang YS, Oh KY, Hur MH, et al. Laparoendoscopic single-site surgery using conventional laparoscopic instruments and glove port technique in gynecology: a single surgeon′s experience[J]. J Minim Invasive Gynecol, 2015, 22(1): 87-93. DOI: 10.1016/j.jmig.2014.07.013.
[20]
Lee YY, Kim TJ, Kim CJ, et al. Single-port access laparoscopic-assisted vaginal hysterectomy: a novel method with a wound retractor and a glove[J]. J Minim Invasive Gynecol, 2009, 16(4): 450-453. DOI: 10.1016/j.jmig.2009.03.022.
[21]
熊光武. 妇科单孔腹腔镜手术器械选择[J]. 中国实用妇科与产科杂志,2019, 35(12): 1324-1326. DOI: 10.19538/j.fk2019120109.
[22]
Lee JH, Choi JS, Jeon SW, et al. A prospective comparison of single-port laparoscopically assisted vaginal hysterectomy using transumbilical GelPort access and multiport laparoscopically assisted vaginal hysterectomy[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 158(2): 294-297. DOI: 10.1016/j.ejogrb.2011.05.002.
[23]
黄晓斌,谢庆煌,柳晓春,等. 经脐单孔腹腔镜与多孔腹腔镜输卵管切除术疗效比较[J]. 中国实用妇科与产科杂志,2015, 31(8): 750-753. DOI: 10.7504/fk2015070117.
[24]
Cipriani F, Catena M, Ratti F, et al. LESS technique for liver resection: the progress of the mini-invasive approach: a single-centre experience[J]. Minim Invasive Ther Allied Technol, 2012, 21(1): 55-58. DOI: 10.3109/13645706.2011.632013.
[25]
Rao PP, Rao PP, Bhagwat S. Single-incision laparoscopic surgery-current status and controversies[J]. J Minim Access Surg, 2011, 7(1): 6-16. DOI: 10.4103/0972-9941.72360.
[26]
Dong J, Zu Q, Shi L, et al. Retroperitoneal laparoendoscopic single-site radical nephrectomy using a low-cost, self-made device: initial experience with 29 cases[J]. Surg Innov, 2013, 20(4): 403-410. DOI: 10.1177/1553350612460768.
[27]
强萍,杨婷婷,邵洋,等. 应用普通器械行改良单孔腹腔镜下输卵管切除术的临床研究[J]. 现代仪器与医疗,2018, 24(5): 108-110. DOI: 10.11876/mimt201805044.
[1] Xiaohui Du, Jianxin Cui. The strategy of D3 lymph node dissection for laparoscopic radical right hemicolectomy on right colon cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 5-8.
[2] Yanbing Zhou, Xiaodong Liu. Choice of digestive tract reconstruction after laparoscopic right colectomy of colon cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 9-13.
[3] Yanhui Zhang, Jiao Zhang, Zhixian Zhu. Effect of indwelling anal tube on anastomotic leakage after laparoscopic total mesangectomy after neoadjuvant chemoradiotherapy in patients with middle and low rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 25-28.
[4] Chunrong Wang, Jiang Chen, Chen Yu. Clinical application of laparoscopic anatomic left hemihepatectomy through Glisson pedicle extrathecal anatomy and Laennec membrane approach[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 37-40.
[5] Shijiang Pang, Yanyan Huang, Guanlie Zhu. Safety and efficacy of modified π-type anastomosis in laparoscopic total gastrectomy for digestive tract reconstruction[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 66-69.
[6] Jianxiong Tang, Shaojie Li. Continue to promote the standardization of laparoscopic hernia surgery in China[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 591-594.
[7] Wen Tian, Xiaodong Yang. Selection and attention of laparoscopic inguinal hernia repair[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 595-597.
[8] Tao Li, Gang Chen, Shiyong Li. Laparoscopic right oblique inguinal hernia repair (TAPP)[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 598-598.
[9] Bo Mo, Pei Wang, Heng Wang, Zhijun He, Jun Liang, Zhinan Hao. Curative effect of laparoscopic radical gastrectomy and modified radical gastrectomy for early gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 644-647.
[10] LuoBu AChong, Ying Chen, Dekun Xie. Effect of laparoscopic complete exocyst dissection in the treatment of hepatic echinococcosis and its influence on liver function and prognosis[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 666-669.
[11] Duojie Suolang, Hongqiao Gao, Dunzhu Basang, Sang Ren. Clinical analysis of different laparoscopic procedures in the treatment of hepatic cystic echinococcosis in Tibet[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 670-673.
[12] Haiqin Tang, Xiuzhi Guo, Xiaosu Zhu, Shidi Zhao. Clinical safety study of "tunnel method" laparoscopic anatomic left hemihepatectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(06): 674-677.
[13] Wenbin Lin, Zeyuan Zheng, Wenneng Zheng, Yigang Yu. Construction of prediction model for risk of conversion to open surgery in patients with traumatic splenic rupture undergoing laparoscopic splenectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 619-623.
[14] Yanjun Lu, Jian Ma, Pengyu Bai, Linghong Guo, Haiyi Liu, Bo Jiang, Wenqi Bai, Yixun Zhang. Clinical effect of Nano-carbon on 253 groups of lymph node dissection in laparoscopic radical resection of rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 473-477.
[15] Bo Li, Gang Hu, Wenlong Qiu, Jianqiang Tang, Xishan Wang. Multifunctional indocyanine green near infrared fluorescence imaging technique in the application of natural norifice specimen extraction surgery for rectum cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(06): 524-528.
Viewed
Full text


Abstract