关键词: 腹腔镜检查, 肾上腺切除术, 输尿管结石, 肾切除术, 肾疾病, 囊性, 肾盂成形术, 经脐单孔腹腔镜

Abstract: Objective    To summarize the surgical techniques of single-port transumbilica laparoscopic surgery in upper urinary tract and adrenalectomy by using a self made port and evaluate its feasibility and safety. Methods  From March 2010 to November 2011, 130 patients were treated with single-port transumbilical laparoscopic surgery, which included 60 cases of renal cystectomy, 6 cases of pyeloplasty, 2 cases of adrenalectomy, 40 cases of ureteral incision, 10 cases of partial nephrectomy, 12 cases of non-functioning kidney resection. The single-port was made up of two rings and a latex glove. A 2 cm incision was made in the middle of umbilicus, and the single-port was then inserted with three trocars (10,10, 5mm) inside. Tradition laparoscopic equipment and flexible laparoscopic instruments were used to perform the procedures, and the removels were taken out from the port. Results   All laparoscopic operations were successfully completed without conversion to open surgery. The addition of ports was necessary in 6 cases as a result of difficult operations and unclear vision. 60 cases of renal cystectomy: mean operative time was (25.2±4.3) min, mean blood loss was (10.3±2.1)ml, mean postoperative hospital stay was (2.5±0.5)d. 6 cases of renal pelvis：mean operative time was (120.9±18.6)min, mean blood loss was (31.5±9.2)ml, mean postoperative hospital stay was (4.0±1.0)d. 2 cases of adrenal operation: operative time was 50 and 60 min respectively, blood loss was 50 and 51 ml respectively, postoperative hospital stay was 3 and 4 d respectively. 40 cases of ureter incision to take stone: mean operative time was (60.0±9.5)min, mean blood loss was (32.1±9.4)ml, mean postoperative hospital stay was (4.0±1.0)d. 10 cases of partial nephrectomy operation: mean operative time was (134.5±15.2) min, (32.5±7.5) min of renal warm ischemia time, mean blood loss was (52.1±11.4)min, mean postoperative hospital stay was (7.0±1.0)d. 12 cases of renal resection operation: mean operative time was (100.8±9.6)min, mean blood loss was (125.7±25.4)ml, mean postoperative hospital stay was (5.0±1.0)d. Postoperative follow-up for 2-33 months, mean 18.2 months, there were no adverse complications. Conclusions    The laparoscopic single-port transumbilical surgery for upper urinary tract and adrenalectomy lesions is safe and feasible, and the cosmetic results are good, but it should be carefully widespread because of its difficulty in the clinical work.

Key words: Laparoscopy, Ureteral Calculus, nephrectomy, pyeloplasy, Laparoendoscopic single-site surgery, LESS, 经脐单孔腹腔镜