| Backgroud:The history of laparoscopic technique in our country has been more than20years,the application of various kinds of operations in the Department of genneral surgery has been widely recognized.In recent years,with the accumulation of the majority minimally invasive surgeon operation experience,and the further reseach and development and production of equipment operation,single-port laparoscopic operation has become the focus of attention at domestic and abroad of lapascopic surgery.Compared with the conventional laparoscopic operation,single-port laparoscopic operation is minimally invasive concept’s practice and further sublimation,it has a lot ofadvantages:For the patients,although the traditional laparoscopic surgery has small trauma,less pain,faster recovery,shorter hospitalization time,has the advantages of no scar in the abdomen.but some patients can still see a few small scars.For the patients with very good-looking,the traditional laparoscopic operation is still difficult to accept,sepcecially unmarried women,more reluctant to let the husband to see a little bit traces. Single-port surgery in addition to the traditional advantages of laparoscopic operation,post-operation almost do not see the scars(including the navel),more in line with the "NO SCAR"operation concept.Those who do not know,do not think they had been operated,great to meet some patients psychological demand,where is the real significance.For the hospitals and patients,the hospital carried out a new technology,can meet the requirements of some patients,build a good platform for the hospital propaganda,attract more patients come for medical treatment.The new technology is an opportunity and a challenge for physicians,they need to learn new theory,new knowledge,use their brains,think of ways to,desigh equipment to complete their own ideas,improve themselves in various aspects.After the success of the development of new technologies,the phyisians published articles,research result will come one after another.Zhejiang Province Peogle’s Hospital of Ministry of health of minimally invasive surgery,endoscopic and minimally invasive medical training base.afford the training task of minimally invasive surgical backbone, this requires us to the introduction of new technology and new method more active. I believe that with the further improvement of professional operation device,with our clinical practice, the difflcuty of this technology will gradually reduce, indications wll be more broad,more beneficial to popularize and apply, so as to enhance the effect of technology in the field of minimally invasive。Zhejiang Province Peogle’s Hospital is one of the earliest laparoscopic operation unit, has been widely carride out laparoscopic operations, such as laparoscopic cholecystectomy, laparoscopic appendectomy, laparoscopic pancreatoduodenectomy and so on, accumulate a large number experience of lapascopic desscetion and digestive tract reconstruction, in addition to be equipped with advanced and complete eqipments and the laparoscopic operation team who they are made up of the doctors and nurses and managers with rich experience in operation, with the development of single-port laparoscopic cholecystectomy equipment and pensonnel condition, Chief physician Wang Zhimin is the first in Zhejiang to carry out the single-port laparoscopic cholecystectomy surgeons, from2014June began to carry out the single-port laparoscopic cholecystectomy, has successfully completed the24cases of transumbilical single-port laparoscopic cholecystectomy, all the patients recoverde well, there were no complications,, no bile leakage, no incisional hernia, there was no injury of intestine, post-operation hospital stay1-2days, achieved the effect of conventional laparoscopic operation, and the incision in the umbilicus, the scars basically do not see after umbilical fibrous scar contraction, patient satisfaction was high, not only achieved minimally invasive anatomic,also received minimally invasive on the heart。Objective:Analysis on data of24cases of transumbilical singel-port laparoscopic cholecystectomy patients, to explore the feasibility and safety of transumbilical single-port laparoscopic cholecystectomy for gallstone disease, to summarize the operation experience of transumbilical single-port laparoscopic operation in the treatment of gallstone disease, and through the analysis and comparison of three-port laparoscopic operation in treatment of cholecystolithiasis,compare the advantages and disadvantages。Methods:During the period of2014June to2014March in Zhejiang Province People’ Hospital were treatde70cases of gallstones (the surgeon was Dr Wang Zhimin,the same operation team) including24cases of transumbilical single-port laparoscopic cholecystectomy(singel-port group). Three-port laparoscopic cholecystectomy in46cases (three-port group). Before operation, we guarantee that every patient (single-port group) and the right of informde consent,and introduce the operation mode,and inform the operation ideally only one incision,less than traditional laparpscopic operation。all patients were informed consent and signde by the said selection of single-port laparoscopic operation。In70patients the numbers of male was22, female was48, the average is (35.73±5.65) years old.Through the clinical data in70patients operative time,blood loss, post-operation hospital stay,total cost of hospitalization were compared and analyzed,to explore the feasibility ande safety of transumbilical single-port laparoscopic cholecystectomy,and compare their advantages and disadvantages.Result:The average operation time of single-port group is (87.36±42.48) min, three-port group is (53.23±17.13) min, the P value is less than0.05, there was statistically significance difference.The amount of intraoperative blood loss of single-port group is (7.35±4.13) ml, three-port group is (6.42±2.37) ml, the P value is greater than0.05,no significant differences between the two groups.The postoperative hospital stay of single-port group is (1.28±0.49)(d), three-port group is (3.43±1.20)(d), the P value is less than0.05, statistically significant differences.The hospitalization expenses of single-port group is (11067.15±678.35)(yuan), thrr-port group is (13209±2438.12)(yuan), the P value is less than0.05, a statistically significant difference..Conclusion:Transumbilical single-port laparoscopic operation in treatment of cholecystolithiasis and cholecystitis is safe and feasible。In addition to the traditional laparoscopic surgery with less bleeding,small trauma,faster post-operative recover,shorter hospitalization time and other advantages,at the same time,the basic realization of no abdominal scat,high patient satisfaction. |
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