[1]刘冰 鲍一 王志向 汪洋 吕晨 杨庆 叶华茂 吴震杰 王林辉 孙颖浩.经腹单孔末端可弯 3D腹腔镜行猪肾盂输尿管成形术的动物实验：附视频[J].中华腔镜泌尿外科杂志(电子版),2015,(01):10-15.[doi:10.3877/cma.j.issn.1674-3253.2015.01.003 ]
　Liu Bing,Bao Yi,Wang Zhixiang,et al.Transperitoneal laparoendoscopic single-site (LESS) pyeloplasty in pig using 3D laparoscope with deflectable tip[J].,2015,(01):10-15.[doi:10.3877/cma.j.issn.1674-3253.2015.01.003 ]
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经腹单孔末端可弯 3D腹腔镜行猪肾盂输尿管成形术的动物实验：附视频()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2015年01期
页码:
10-15
栏目:
临床研究
出版日期:
2015-07-31

文章信息/Info

Title:
Transperitoneal laparoendoscopic single-site (LESS) pyeloplasty in pig using 3D laparoscope with deflectable tip
作者:
刘冰 鲍一 王志向 汪洋 吕晨 杨庆 叶华茂 吴震杰 王林辉 孙颖浩
200433 上海，第二军医大学附属长海医院泌尿外科
Author(s):
Liu Bing;  Bao Yi;  Wang Zhixiang;  Wang Yang;  Lyu Chen;  Yang Qing;  Ye Huamao;  Wu Zhenjie;  Wang Linhui;  Sun Yinghao.
Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
关键词:
肾盂输尿管成形术; 单孔; 末端可弯;  3D; 腹腔镜
DOI:
10.3877/cma.j.issn.1674-3253.2015.01.003
摘要:
目的初步尝试经腹单孔多通道末端可弯 3D腹腔镜行猪肾盂输尿管成形术，评估 3D单孔腹腔镜肾盂输尿管离断成形术的可行性，总结使用末端可弯 3D腹腔镜的经验及操作难点。方法猪全麻后取仰卧位，向左摇床 30°，取经右侧腹直肌切口，长约 3 cm，逐层切开至腹腔后，置入 Olympus单孔多通道系统（ Quad-Port）建立操作通道。充入 CO2，气腹压达 14 mmHg，置入 Olympus 10 mm末端可弯 3D腹腔镜及预弯器械，打开侧腹膜，沿肾盂向下游离 3 cm长的输尿管，离断并上下纵行剖开 1 cm。用 4-0可吸收线连续缝合输尿管前壁并打结，翻转输尿管 180°后连续缝合后壁。完成吻合前置入双 J管，最后间断缝合 3针完成缝合。结果在不增加额外通道的情况下顺利完成手术，手术时间 68 min。为了实践练习单孔腹腔镜下缝合技术，共缝合猪输尿管 11针，用时 53 min。术中出血少，无术中并发症。结论经腹单孔多通道 3D腹腔镜下肾盂输尿管成形术安全、可行，但手术操作难度较大。配合使用末端可弯 3D腹腔镜及可弯、预弯器械，使得手术图像立体感强，视野更加灵活，手术操作精确度高，有效降低单孔器械“打架”及手眼协调难度。

参考文献/References:

[1] Rané A, Rao P, Rao P. Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port)[J]. Urology, 2008, 72(2): 260-263; discussion 263-264.
[2] Desai MM, Rao PP, Aron M, et al. Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report [J]. BJU Int, 2008, 101(1): 83-88.
[3] Kaouk JH, Goel RK, Haber GP, et al. Single-port laparoscopic radical prostatectomy[J]. Urology, 2008, 72(6): 1190-1193.
[4] Kaouk JH, Goel RK, White MA, et al. Laparoendoscopic single-site radical cystectomy and pelvic lymph node dissection: initial experience and 2-year follow-up [J]. Urology, 2010, 76 (4): 857-861.
[5] Moon DA, El-Shazly MA, Chang CM, et al. Laparoscopic pyeloplasty: evolution of a new gold standard [J]. Urology, 2006, 67(5): 932-936.
[6] Symons SJ, Bhirud PS, Jain V, et al. Laparoscopic pyeloplasty: our new gold standard[J]. J Endourol, 2009, 23(3): 463-467.
[7] Rais-Bahrami S, Rizkala ER, Cadeddu JA, et al. Laparoendoscopic single-site pyeloplasty: outcomes of an international multi-institutional study of 140 patients [J]. Urology, 2013, 82 (2): 366-372.
[8] 王林辉 ,刘冰 ,王志向 ,等.中国首例单孔多通道经腹 3D腹腔镜肾切除术[J].第二军医大学学报, 2013, 34(10): 1116-1120.
[9] Pelosi MA, Pelosi MA. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy)[J]. J Reprod Med, 1992, 37 (7): 588-594.
[10] Raman JD, Bensalah K, Bagrodia A, et al. Laboratory and clinical development of single keyhole umbilical nephrectomy [J]. Urology, 2007, 70(6): 1039-1042.
[11] Barret E, Sanchez-Salas R, Kasraeian A, et al. A transition to laparoendoscopic single-site surgery (LESS) radical prostatectomy: human cadaver experimental and initial clinical experience[J]. J Endourol, 2009, 23(1): 135-140.
[12] Nagabhushana M, Kamath AJ, Manohar CS. Laparoendoscopic single-site surgery in urology using conventional instruments: our initial experience[J]. J Endourol, 2013, 27(11): 1354-1360.
[13] Alaraimi B, El Bakbak W, Sarker S, et al. A randomized prospective study comparing acquisition of laparoscopic skills in three-dimensional (3D) vs. Two-dimensional (2D) laparoscopy [J]. World J Surg, 2014, 38(11): 2746-2752.
[14] Cicione A, Autorino R, Breda A, et al. Three-dimensional vsstandard laparoscopy: comparative assessment using a validatedprogram for laparoscopic urologic skills[J]. Urology, 2013, 82(6):1444-1450.
[15] Bilgen K, Ustün M, Karakahya M, et al. Comparison of 3Dimaging and 2D imaging for performance time of laparoscopiccholecystectomy[J]. Surg Laparosc Endosc Percutan Tech, 2013,23(2): 180-183.
[16] Fifer GL, Raynor MC, Selph P, et al. Robotic ureteralreconstruction distal to the ureteropelvic junction: a large singleinstitution clinical series with short-term follow up[J]. J Endourol,2014, 28(12): 1424-1428
[17] SamarasekeraD, Stein RJ.Robotic-assisted laparoscopic approachesto the ureter: Pyeloplasty and ureteral reimplantation[J]. Indian JUrol, 2014, 30(3): 293-299.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金项目（81172447），上海市自然科学基金（11ZR1447800）
通讯作者：王林辉，Email: wlhui@medmail.com.cn
更新日期/Last Update: 1900-01-01