| Objective To investigate the clinical features and surgical techniques of transumbilical single-port laparoscopic surgery for benign gynecological diseases in xxx Medical University General Hospital.Methods A total of 1802 patients who received transumbilical single-port laparoscopic surgery for gynecological benign diseases in xxx Medical University General Hospital from January 2018 to December 2020 were retrospectively collected and analyzed.According to patients’ operation time divided into: group A(January-December 2018),204 cases and group B(January-December 2019),1031 cases of group C,(January-December 2020),567 cases of clinical data collection of groups of patients with general,type of surgery,surgery,preoperative and perioperative secondary surgery and postoperative related indicators,assessment in nearly three years to carry out the change trend of umbilical single-arch laparoscopic treatment of benign disease of department of gynaecology and surgical techniques.Results 1.Nearly three years after the umbilical single-arch laparoscopic carrying case:self courtyard gynecology ward in the umbilical single-arch laparoscopic surgery since TU-LESS ratio is on the rise,1802 cases of the umbilical single-arch laparoscopic surgery are completed smoothly,no 1 case transferred laparotomy or porous method,no intraoperative bleeding,adjacent viscera injury,postoperative complications such as bleeding,infection of incision,navel incision.2.The distribution of surgical diseases and surgical methods and the overall trend of changes were as follows: 906(50.28%)cases of benign adnexal diseases,668(37.07%)cases of uterine diseases and 228(12.65%)cases of ectopic pregnancy were the main diseases.On operation in the umbilical single-arch laparoscopic surgical appendix tumor removal,605(33.57%),followed by uterine fibroids/adenomyoma eliminate a total of 388(21.53%)cases and 290 total hysterectomy(16.09%)cases of application,and as time increases,the umbilical single-arch laparoscopic application is on the rise,among them the most significant of its application in 2019.3.Comparison of intraoperative conditions in three years: The operative time and intraoperative blood loss of group C were significantly shorter than that of group B,and that of group B was less than that of group A(F=4.250,P < 0.05;F=14.578,P < 0.05).The operative time and intraoperative blood loss of salpingectomy group C were significantly shorter than that of group B,and that of group B was less than that of group A(F=6.399,P <0.05;F=25.507,P < 0.05).The operative time and intraoperative blood loss of group C in adnexal tumor excision were significantly less than that of group B,and that of group B was less than that of group A(F=9.121,P < 0.05;F=5.580,P < 0.05).The operative time and intraoperative blood loss of group C in adnexectomy were significantly shorter than that of group B,and group B was less than that of group A(F=11.432,P < 0.05;F=9.262,P < 0.05).The operative time and intraoperative blood loss of group C were significantly shorter than that of group B,and that of group B was less than that of group A(F=20.250,P < 0.05;F=18.897,P < 0.05).In total hysterectomy,the operative time,intraoperative blood loss and total hospitalization time of group C were significantly less than that of group B,and group B was less than that of group A(F=7.511,P < 0.05;F=3.623,P < 0.05).With the prolongation of the application time of transcumbilical single-port laparoscopy,the operative time and the amount of bleeding were significantly reduced,and the surgical operation became more skilled.4.Comparison of postoperative recovery: the total hospitalization time of group C was significantly less than that of group B in single-port transumbilical laparoscopic adnexectomy,adnexectomy and total hysterectomy,and group B was less than that of group A(F=17.703,P< 0.05;F=21.430,P < 0.05;F=3.734,P < 0.05).None of the 1802 patients suffered from postoperative complications such as umbilical incision bleeding and infection during postoperative hospitalization,and all of them were discharged from hospital in good general condition.Conclusion 1.Transumbilicl single-port laparoscopic treatment of benign gynecological diseases presents an increasing trend year by year,and the operation is safe,reliable and has a high success rate.2.With the improvement of surgical techniques and technical proficiency,the time of single-port laparoscopic surgery is gradually shortened,the amount of blood loss and complications show a decreasing trend,and the clinical application effect is good.3.The improvement of surgical techniques is based on the use of self-made gloves and incision protective sleeve approach platform.Different surgical methods have different surgical techniques,faster postoperative recovery,more concealed and beautiful umbilical incision,lower medical costs,and easier to be accepted by patients.Therefore,it can be promoted and used in surrounding areas and subordinate hospitals. |
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