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目的总结经脐单孔腹腔镜Ivanissevich手术经验。方法回顾分析26例经脐单孔腹腔镜Ivanissevich手术的临床资料。术中应用hamlock夹闭并切断精索静脉11例(hamlock组),应用超声刀凝闭并切断精索静脉15例(UAS组)。结果 26例手术均获成功,睾丸动脉均得以保留。手术时间(23.5±9.8)min,出血量(6.7±4.6)mL,无腹腔脏器损伤或术后大出血等并发症,术后住院(1.69±0.92)d。hamlock组比UAS组手术时间明显延长(P<0.01)。结论经脐单孔腹腔镜保留睾丸动脉的精索静脉曲张高位结扎术安全可行,随着技术的娴熟、更为高位的分离精索静脉、单孔套管及操作器械的改进和超声刀的应用,使得手术操作更为简单,完全可以取代传统腹腔镜手术成为首选术式。
Objective To summarize the experience of transvaginal laparoscopic Ivanissevich surgery. Methods The clinical data of 26 cases of transvaginal laparoscopic Ivanissevich operation were retrospectively analyzed. Intraoperatively, hamlock was used to occlude and sever the spermatic vein in 11 cases (hamlock group). Fifteen cases (UAS group) were closed and sutured by sonicator. Results All the 26 surgeries were successful. The testicular arteries were preserved. The operation time (23.5 ± 9.8) min, bleeding volume (6.7 ± 4.6) mL, no complications of abdominal organ injury or postoperative hemorrhage, postoperative hospital stay (1.69 ± 0.92) d. The operation time in hamlock group was significantly longer than that in UAS group (P <0.01). Conclusions The high umbilical single hole laparoscopic preservation of the testicular artery varicocele ligation is safe and feasible, with the skill of the more advanced separation of the varicocele, single-hole casing and operating equipment improvements and the application of ultrasonic knife , Making the operation more simple and can replace traditional laparoscopic surgery as the preferred surgical procedures.