Techniques And Improvements Of Natural Orifice Transumbilical Surgery

Background:Laparoscopy surgery is an important part of minimally invasive surgery. Because of its Less trauma,postoperative pain and lighter,shorter hospital stay, cosmetic results and good features,in the widely used worldwide.Its development has brought about major changes in the field of minimally invasive surgery and the whole surgical. Flourishing today in laparoscopic, Clinicians are committed to further reduce the surgical trauma and achieve better cosmetic results. Natural orifice transumbilical surgery is inserted the tube with single or multiple operating channel on through umbilical channel,then inserted the Surgical instruments through the operating channel to complete surgical procedures.And remove the specimen by the umbilical. Navel is the only natural scar on the body surface. Umbilical incision after healing was covered by the original umbilical skin fold. Here is no postoperative abdominal wall scar.Umbilical scar hidden,and appearance should not be aware of. Can achieve good cosmetic results. Research of NOTUS has been conducted within the scope of the world. Because its technology is more complexity than common laparoscopy surgical techniques and it has higher requirements for equipment,it is still a new technology in the domestic clinical and hasn't been widely used. Since November 13, 2008 the successful implementation of one case of transumbilical single port laparoscopic cholecystectomy in patients with gallstone, Qilu Hospital of Shandong University has been carried out 28 cases of transumbilical single port laparoscopic cholecystectomy in patients,including 12 cases of pneumoperitoneum and 16 cases of non-pneumoperitoneum.And carried out the first suspended transumbilical single-port laparoscopic liver cyst fenestration for a person with hepatic cyst on May 30, 2009,which is verified the first worldwide. The first suspended transumbilical single-port laparoscopic cholecystectomy for a patient with gallbladder polyps was carried out in Qilu hospital on June 18,2009,and proved the first worldwide,too.Objective:Explore the operation methods and techniques of natural orifice transumbilical surgery. Investigate the feasibility, clinical values and indications of natural orifice transumbilical surgery.Methods:Review of November 2008 so far Qilu Hospital of Shandong University via transumbilical single-port laparoscopic cholecystectomy in the clinical data of 28 patients.Results:All the 28 operation were successfully performed without open surgery.12 patients with pneumoperitoneum transumbilical single-port laparoscopic cholecystectomy, and 16 patients with suspended transumbilical single-port laparoscopic cholecystectomy. Except for the first time 189 minutes operative patients, the remaining operation time in patients with 45-110 minutes, and mean operation time of about 60minutes.5-10 ml of blood loss, No stomach tube orthe catheter was placed and postoperative bleeding andbiliary leakage didnt occur. Apart from 1 patient postoperative analgesic once outside the other patients had no significant pain. All patients were awake, ready for water. The times of hospitalization were 1-2 days. There were no visible scars on the abdominal wall after 2 weeks.Conclusions:Under current conditions to carry out natural orifice transumbilical surgery is safe and feasible. Compared with traditional laparoscopic surgery, natural orifice transumbilical surgery is more difficult. The main technical difficulty lies in the establishment of operational f space and avoid interference between devices. The umbilical operation device and surgical instruments need to be further refined and improved. But it's more minimally invasive, and better cosmetic results, with high clinical value. With the scientific and technological progress, is expected to replace the existing laparoscopic surgery in some areas.