| As a transition between conventional laparoscopic technology and NOTES (natural orifice transluminal endoscopic surgery), single-port laparoscopy surgery(LESS) has acquired attention greatly for its lower surgical trauma and the minimal abdominal wall incision in recent years, Meanwhile, the corresponding device also emerge in endlessly. But, the market price of LESS device is high which increased the burden of the patients with no doubt. Though the price of some homemade device is relatively cheap, the shortcomings is very obvious, such as the air impermeabilit, poor flexibility and so on. In order to integrated the advantages and reduce the deficiency mentioned above as far as possible, We develop a set of LESS device independently. After two years of clinical application, we have acquired satisfactory results no matter in safety and practicality,-or in the postoperative rehabilitation and patients satisfaction.In addition, the application of LESS in colorectal surgery has got the rapid development. Afrer retrospecting the previous research results and related clinical practice experience, we found some deficiency of LESS, such as high operation difficulty and long operation time. we gradually fish out a set of operation path and programme it which significantly reduce the operation difficulty and shorten the operation time significantly. results in ensuring the surgery quality at the same time with no discount in operation safety and efficiency. Section one:Clinical study of homemade single-site device Objective Through introducing the maneuverability and availability of the homemade single-site device, we strongly recommend it is worthy of popular application.Methods We detailedly introduce production steps of this device, and make a retrospective analysis of70cases underwent LESS with this device from2009-12to2011-12with the operation time, intraoperatie bleeding, and hospital stay for the reference index.Results65cases experienced surgery successfully without Intraoperative conversion.5cases were made a conversion to the open surgery. The operative time ranged from90to300min. The Intraoperative blood loss was10to120ml. The hospital stay was1to5days.Conclusions The homemade single-site device be of preferable maneuverability and availability, and it was cheap. It should be applicated popularly.Section two:Clinical study of the programmed surgery path for right colon laparoendoscopic single-site resectionObjective Try to combine the laparcrendoscopic single-site technology with a programmed Surgery path for right Colon resection, which can Improve operation efficiency, Shorten operating time and reduce intraoperatie bleeding.Methods We select80patients with colon cance from2009-12to2011-11, Which were randomly divided into conventional laparoscopic group (n=40) and LESS group (n=40). The programmed Surgery path for right Colon resection was practised in LESS group. We confirmed the feasibility of this surgery path with the index incuding operation time, intraoperative blood loss and postoperative pain score (VAS) and so on. Results All cases experienced surgery successfully withoutIntraoperative conversion.operation time were110.9±23.5min and120.0±15.7min (P>0.05), intraoperative blood loss were45.4±10.4ml and10.8±4.0ml (P<0.05), numbers of cleaning lymph node were11.7±1.2and10.7±1.3(P>0.05), length of incision were5.5±0.7cm and3.4±0.5cm (P<0.05). VAS scores: the first postoperative day were7.23±1.22and1.22±0.82(P<0.05), the next day after operation were3.87±1.50and1.50±0.91(P<0.05), the third day after surgery were1.00±1.14and1.14±0.38(P<0.05). All patients were satisfactory with the postoperative cosmetic effect. Conclusions Combineing the laparoendoscopic single-site technology with a programmed Surgery path for right Colon resection is feasible, which is worth of promoting. |
