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目的:探讨自制单口装置行单孔后腹腔镜手术治疗各种泌尿系统疾病的安全性和可行性。方法:使用自制单口装置对114例患者行单孔后腹腔镜泌尿外科手术,包括2个控制环和1个8号无粉外科手套组成一个单孔多通道操作器械,使用常规腹腔镜器械进行后腹腔镜手术。其中60例行根治性肾切除术,15例行根治性肾输尿管全长切除术,19例行肾部分切除术(包括1例同时行对侧肾上腺腺瘤切除术),11例行亲属活体供肾切取术,6例行肾上腺肿瘤切除术(包括1例同时行同侧肾囊肿去顶术),2例行肾囊肿去顶术,1例行输尿管切开取石术。结果:114例患者均经单孔后腹腔镜手术成功,无改行常规腹腔镜手术或开放手术。手术时间40~340min,平均137.14min;术中出血5~600ml,平均63.82ml;住院时间6~36d,平均12.71d。无任何重大手术并发症,所有患者均表示满意。结论:应用自制单口装置行泌尿外科单孔后腹腔镜腔镜手术是安全可行的,费用低,可进一步减轻患者创伤,是一种有广阔应用前景的手术治疗方案。
Objective: To investigate the safety and feasibility of a single-hole laparoscopic surgery in the treatment of a variety of urinary system diseases. METHODS: One-hole post-laparoscopic urologic surgery was performed on 114 patients using a self-made single-port device consisting of two control rings and one No. 8 powder-free surgical glove to form a single-hole multi-channel manipulator that was performed using conventional laparoscopic instruments Laparoscopic surgery. Among them, 60 cases underwent radical nephrectomy, 15 cases underwent radical nephroureterectomy, 19 cases underwent partial nephrectomy (including 1 cases of contralateral adrenal adenoma resection) and 11 cases of relative living donor Renal resection, 6 cases of adrenalectomy (including 1 case of ipsilateral renal cyst debridement), 2 cases of renal cyst debridement, and 1 case of ureteral incision and lithotomy. Results: All 114 patients underwent laparoscopic surgery after one-hole operation without any routine laparoscopic or open surgery. Surgery time 40 ~ 340min, an average of 137.14min; intraoperative bleeding 5 ~ 600ml, an average of 63.82ml; hospital stay 6 ~ 36d, an average of 12.71d. Without any major surgical complications, all patients were satisfied. Conclusion: It is safe and feasible to use laparoscopic endoscopic urology single-hole laparoscopic surgery with self-made single-port device. It is a safe and feasible method to reduce the trauma of patients with low cost. It is a promising surgical treatment.