门诊局麻下微型腹腔镜精索内静脉高位结扎术

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1、临床泌尿外科杂志庭资源系统WXMPANGO*TACCMINAIN^ObJOURNALOFCLINICALUROLOGY2000Vol.15No.4P.161-163门诊局麻下微型腹腔镜精索内静脉高位结扎术(附127例报告)陈泽波彭毅蔡志明黄东平叶秀桃李太富张俊刚摘要目的：改变泌尿外科患者需入院一开刀一抗感染一拆线一岀院等传统治疗模式，改变常规腹腔镜手术需全麻、费用高、体内残留金属异物的状况。方法：采用局麻，在门诊应用肓径4mm微型腹腔镜及丝线作精索内静脉高位结扎治疗精索静脉曲张127例。结果:127例全部完成手术，术时未见明显出血及脏器损伤，无一例中转

2、手术。术后随访106例，精索静脉曲张复发率为7.5%o结论：本术式是一种医患均乐意接受的新术式，可作为当天外科的一个项目。关键词微型腹腔镜精索静脉曲张局部麻醉精索内静脉高位结扎术Mini-laparoscopicligationofspermaticveinsinoutpatientswithvaricoceleunderlocalanesthesia(Reportof127cases)CHENZe-boPENYiCAIZhi-mingHUANGDong-pingYEXiu-tao(DepartmentofUrology,LuohuRegionHosp

3、ital,ShenzhenCity,Guangdong,518001)LITai-fuZHANGJun-gang(DcpartmcntofAnesthesia,LuohuRegionHospital,ShenzhenCity,Guangdong)AbstractPurpose:Anincreasingnumberofoperativeproceduresinurologycanbeperformedbylaparoscopy.Wereportourexperieneewithmini-laparoscopicspermaticveinsligation

4、bysilksuturc,whichisatypicaloperativcinoutpatientsofvaricoceleandasimpletechniqueforsutureligation.Methods:Mini-laparoscopicspermaticveinligationbysilksuturewasperformedin127outpaticnts(12to37yearsolds,28bilatcreiland99unilateral)sinceNov.1993.Withthepatientunderlocalanesthesiat

5、hepneumoperitoneumwasinduecd,three-4nun-trocarswereinserted,thespermaticveinswereligturedbysilksutureandtheretroperitoneumwassuturedbysilksuture.ResuIts:Alloperationswerecomplctcdasplarmcdunderlocalancsthesis.Bloodlosswasmoreminimalandtherewerenointraoperativeorpostoperativecomp

6、lications.Meanpostoperativehospitalstayis2hours.Conclusions:Minilaparoscopicspermaticveinligationisfeasibleandminimal1yinvasive.Thisprocedurecanbeperformedinoutpatientsandit'saneffectiveemdsimpletreatmentforvaricocele.It7satechniqueofDaySurgery.KeywordsMini-laparoscopyVaricocele

7、LocalanesthesiaHigh1igationofinternalspermaticcordvein自我们1992年12月成功地开展了屯视腹腔镜精索内静脉高位钛夹夹闭术以来，为了改变患者需住院、全麻、费用高等状况，我们在腹腔镜操作技术逐渐熟练以后，于1993年11月开始对127例精索内静脉曲张(VC)患者在局麻下采用微型腹腔镜用丝线在腹膜后对精索内静脉进行高位结扎，用内镜缝合技术对后腹膜切口进行缝扎关闭，结果患者术后即可返家，彻底改变了需住院治疗的现状，效果满意，现报告如下。1资料与方法1.1一般资料本组127例，年龄12〜37岁，平均26.7

8、岁，其中16岁以上119例。男性不育48例，阴囊坠胀不本课题受深圳市科学基金资助，获1997年