Objective To summarize the experience of single incision laparoscopic colorectal surgery and to discuss the operative techniques. Methods The clinical data of 21 cases who underwent single incision laparoscopic colorectal surgery in Shengjing Hospital from Jan. 2010 to Jun. 2011 were collected and analyzed. Results Of 21 cases underwent single incision laparoscopic surgery， right hemicolectomy performed in 5 cases， sigmoidectomy performed in 2 cases， rectal anterior resection performed in 9 cases， rectal abdominoperineal resection performed in 2 cases， total colectomy performed in 1 case， and colostomy performed in 2 cases. Twenty cases completed by single incision， but 1 case was added an extra 12 mm incision in order to dissect the lower segment of rectum. The operative time was （189±75） min （40-335min）；the postoperative hospitalization time was （11.5±3.4） d （7-16d）. There were no bleeding， anastomosis leakage or intestinal obstruction after operation， and no incision infection， rupture or hernia were founded. No recurrence was found within 6 months’ follow up after operation. Conclusions Under reasonable selection of indication， single incision laparoscopic colorectal surgery is safe and feasible， and it also has a satisfactory cosmetic effect and better minimally invasive effect.
ObjectiveTo evaluate the efficacy of myomectomy via transumbilical laparoendompic single-site surgery (TU-LESS) and traditional multiport laparoscopy.MethodsThe study was conducted at Chengdu Western Hospital from June 2019 to June 2020. Fifty patients underwent TU-LESS myomectomy (TU-LESS group), while another 50 patients underwent traditional multiport laparoscopic myomectmy (multiport laparoscopy group). The conditions of operation, extra analgetic usage, VAS grade, and patients’ satisfaction degree were compared between two groups.ResultsPatients in both groups had similar age, BMI, fibroma volume, operative time, expelling gas day, blood loss, complication rate, and hospitalized costs (P>0.05). Compared with traditional multiport laparoscopy, the TU-LESS group resulted in significantly shorter hospitalization day, lower VAS score of the 1st/3nd/7th days after surgery, less use of analgetic after surgery, and higher satisfaction degree.ConclusionsTU-LESS is safe and feasible for myomectomy, and it is associated with less pain, shorter hospitalization day, and higher satisfaction degree.
目的探讨经脐单孔腹腔镜联合胃镜治疗微小胃间质瘤(gastric stromal tumors, GIST)的可行性和临床疗效。 方法回顾性分析我院2010年10月至2011年5月期间行经脐单孔腹腔镜联合胃镜治疗微小GIST 30例患者的临床资料。 结果30例病灶直径（1.0±0.2） cm（0.5～2.0 cm），术后病理检查均证实为极低危险程度GIST。 24例在单孔腹腔镜辅助下成功完成内镜黏膜下剥离术（endoscopic submucosal dissection，ESD）； 3例因ESD术中发生胃壁穿孔而改行内镜全层切除术（endoscopic full-thickness resection, EFR），其中2例继续在单孔下完成穿孔修补术，1例于左上腹壁另加一 Trocar，在双孔下完成穿孔修补术； 另3例因ESD剥离瘤体困难，改行胃局部切除术，其中2例继续在单孔下完成手术，1例在双孔下完成手术。 ESD成功率为80.0%（24／30），经脐部单孔完成率为93.3%（28/30）。手术时间（87.5±10.3） min （45～150 min）。 全组术后（4.3±0.5） d （3～8 d）出院。术后随访期3～7个月（平均4.6个月），均无病变复发。 结论经脐部单孔腹腔镜联合胃镜治疗微小GIST是安全可行的，早期疗效令人满意。
ObjectiveTo systematically evaluate the effect of single-port totally extraperitoneal (SPTEP) and conventional totally extraperitoneal (CTEP) inguinal hernia repair in treatment of inguinal hernia. MethodsPubMed, Cochrane Library, Embase, WanFang Data, VIP, and CNKI databases were electronically searched and the randomized controlled trial (RCT) and non-RCT studies on the efficacy and safety of SPTEP versus CTEP for patients with inguinal hernia from January 2010 to November 2019 were collected. Two reviewers independently screened literatures, extracted data, and assessed risk of bias of included studies, then the meta-analysis was performed by using RevMan5.3 software. ResultsA total of 17 clinical studies were included in the analysis, with 1 106 cases in the SPTEP group and 966 cases in the CTEP group. The results of meta-analysis showed that: the hospital stay [SMD=–0.12, 95%CI (–0.22, –0.02), P=0.01] and the time to resume normal activity [SMD=–1.17, 95%CI (–2.10, –0.23), P=0.01] were shorter, the satisfaction score of incision scars [SMD=0.92, 95%CI (0.31, 1.53), P<0.01] was higher in the SPTEP group as compared with the CTEP group. However, the operative time of SPTEP group was longer than that of the CTEP group both for unilateral inguinal hernia [MD=4.08, 95%CI (0.34, 7.83), P=0.03] and bilateral inguinal hernia [MD=5.53, 95%CI (0.39, 10.68), P=0.04]. There were no statistical differences in the postoperative pain score (24 h and 7 d), incidence of postoperative complications, the rate of patients satisfied with the incision, and hospitalization costs between the two groups (P>0.05). ConclusionsFrom the results of this meta-analysis, SPTEP has some certain advantages in shortening hospital stay and returning to normal activity time, and improving incision satisfaction. However, compared with CTEP, mean operative time of SPTEP is longer. Although SPTEP has developed for several years, it is difficult to replace CTEP.
目的 探讨利用常规腹腔镜器械完成经脐单孔腹腔镜结直肠手术的可能性和技术要点。方法 收集中国医科大学附属盛京医院微创外科于2009年4月至2010年1月期间施行的12例经脐单孔腹腔镜结直肠手术的临床资料。阑尾炎8例，均为女性，平均年龄40岁； 回盲部肿物2例，均为女性，其中1例为回盲部淋巴水瘤（68岁），另1例为回盲部溃疡性结肠炎（47岁）； 乙状结肠息肉1例，女，55岁； 直肠癌1例，男，52岁。 12例均于脐部行2.5~3.0 cm长单切口，利用常规腹腔镜手术器械完成手术。结果 8例阑尾手术，手术时间20~50 min，出血量均少于10 ml； 2例回盲部切除术手术时间分别为60 min和90 min，出血量分别为10 ml和20 ml； 1例乙状结肠切除术用时120 min，术中出血约50 ml，术后4 d拔除引流管； 直肠癌手术时间210 min，术中出血少于200 ml，术后1周拔除引流管并出院。结论 利用常规腹腔镜手术器械完成经脐单孔腹腔镜结直肠手术安全可行。
ObjectiveTo analyze safety and feasibility of transumbilical single-incision laparoscopic assisted ventriculoperitoneal shunting. MethodsThe clinical data of 36 patients who diagnosed as hydrocephalus underwent ventriculoperitoneal shunting from May 2013 to August 2015 in this hospital were collected. Twelve patients were performed transumbilical single-incision laparoscopic assisted ventriculoperitoneal shunting (laparoscopy group) and 24 patients were performed laparotomy ventriculoperitoneal shunting (laparotomy group). The abdominal operation time, postoperative exhaust time, postoperative hospital stay, postoperative pain score, and postoperative complications rate were compared between the laparoscopy group and the laparotomy group. ResultsAll the operations were completed successfully. Compared with the laparotomy group, the abdominal operation time (P < 0.05), postoperative exhaust time (P < 0.05), and postoperative hospital stay (P < 0.05) were significantly shorter, the postoperative pain score was significantly less (P < 0.05) in the laparoscopy group. The postoperative complications rate had no significant difference between the laparoscopy group and the laparotomy group (P > 0.05). ConclusionsThe preliminary results of limited cases in this study show that transumbilical single-incision laparoscopic assisted ventriculoperitoneal shunting is safe and feasible, with better cosmetic. more comparative studies or randomized controlled trials are required to make a confirmed conclusion.
ObjectiveTo compare clinical efficacy between transumbilical three-port laparoscopic surgery (TU-TPLS) and transumbilical single-incision laparoscopic surgery (TU-SILS) in repair of acute peptic ulcer perforation. MethodsThe patients with acute peptic ulcer perforation who underwent TU-TPLS or TU-SILS in Chengdu Second People’s Hospital Affiliated to Sichuan University from January 2022 to December 2024 were retrospectively collected, and then were divided into the TU-TPLS group and TU-SILS group. The operation time, postoperative 24 h incision pain score (visual analogue scale) , postoperative hospital stay, total hospitalization cost, incision scar score (Vancouver scar scale), comprehensive satisfaction, and postoperative complications were compared between the two groups. ResultsA total of 105 patients met the inclusion criteria were enrolled, comprising 50 patients in the TU-TPLS group and 55 patients in the TU-SILS. There were no statistically significant differences in baseline characteristics between the two groups, such as gender, age, body mass index, perforation site, perforation diameter, and Boey score (all P>0.05). Postoperatively, the TU-TPLS group demonstrated significantly lower visual analogue scale pain score at 24 h compared to the TU-SILS group [(2.34±0.63) score vs. (3.22±1.05) score, P<0.001] and significantly higher comprehensive satisfaction score [(7.60±0.86) score vs. (7.02±1.01) score, P=0.002]. However, no statistically significant differences were observed between the TU-TPLS group and TU-SILS group regarding operative time [(71.84±10.51) min vs. (69.78±7.98) min, P=0.257], postoperative hospital stay [(10.35±2.08) d vs. (9.96±1.75) d, P=0.310], or total hospitalization costs [(20 856.23±4 095.73) yuan vs. (19 988.83±2 933.43) yuan, P=0.212]. The incidence of umbilical wound infection was 1 case in the TU-TPLS group and 3 cases in the TU-SILS group (P=0.619). Postoperative residual intra-abdominal infection occurred in 2 cases in the TU-TPLS group and 1 case in the TU-SILS group (P=0.604). Incisional bleeding occurred in 0 cases in the TU-TPLS group and 1 case in the TU-SILS group (P>0.999). Furthermore, there was no statistically significant difference in the scar assessment score between the TU-TPLS group and TU-SILS group [(3.11±1.13) score vs. (2.92±0.70) score, P=0.301] at the 2-month postoperative follow-up. ConclusionsBoth TU-TPLS and TU-SILS have achieved good therapeutic effects in treatment of acute peptic ulcer perforation. However, TU-TPLS has more advantages over TU-SILS. TU-TPLS causes milder incision pain, leads to higher patient satisfaction, and does not require special equipment.
Single-incision laparoscopic sleeve gastrectomy (SILSG) was first described in 2008, which could effectively control excess body weight and treat metabolic diseases relevant to obesity in a long term. Over more than a decade of refinement and technical advancement, precise and standardized surgical techniques have become critical for ensuring treatment efficacy and reducing postoperative complication rates. Thus, this review summarized the evolution of SISLG, further understanding and emphasizing the importance of standardized and precise surgical procedures.