BackgroundSingle-incision laparoscopic surgery (SILS), which has been demonstrated to be
safely applied on kinds of surgeries, may represent an improvement over
conventional multi-port laparoscopic surgery. However, there are still few
clinical experiences of SILS in pancreatic surgery until now. In this study, we
will summarize our experience of transumbilical single-incision laparoscopic
distal pancreatectomy (TUSI-LDP), and compare its related parameters with
conventional multi-port laparoscopic distal pancreatectomy (C-LDP).MethodsA retrospective analysis was conducted for the patients who underwent C-LDP or
TUSI-LDP in our department. The demographic data, operative parameters, and
postoperative complications in the two groups were summarized and compared.ResultsLaparoscopic distal pancreatectomy was performed in a total of 21 cases, among
which TUSI-LDP was performed in 14 cases. As far as the demographical results
concerned, there were no significant differences between the two groups. The
conversion to open surgery was conducted in one case in the TUSI-LDP group because
of severe adhesion between pancreatic cyst and surrounding tissues, while in the
C-LDP group the only one conversion was for the difficult detection of small
lesion. The mean operating time and intraoperative blood loss in TUSI-LDP group
was a little shorter (166.4 ± 57.4 versus 202.1 ± 122.5 minutes, p > 0.05, and
157.1 ± 162.4 versus 168.6 ± 157.4 ml, p > 0.05). The postoperative pain and
post-operation lengths of hospital stay in the TUSI-LDP group were also less,
though there was no significant statistical difference between the two groups. For
the post-operation complications, in TUSI-LDP group the pancreatic leakage
occurred in only one case, and ceased spontaneously with only a drain for 61 days.
There were no other complications including postoperative hemorrhage, venous
thrombosis, infections and so on in both groups.ConclusionFor the experienced laparoscopic surgeons, in selected patients, TUSI-LDP is a
feasible technique, with excellent cosmetic effect, less postoperative pain and
post-operation lengths of hospital stay. With the experience accumulated, the
operating time and intraoperative blood loss of TUSI-LDP could also gradually
reduce.
Choledochoscopy is an important treatment option for hepatolithus. It has a high efficiency for stone extraction and fewer complications. However, it should be noted that some of its complications are potentially life-threatening.
Creating adhesion between the left lateral lobe of the liver and the diaphragm using NBCA glue is a simple, safe and effective way of achieving liver retraction in single-incision laparoscopic upper abdominal surgery.
Single-port access transaxillary totally endoscopic partial thyroidectomy appears to be safe and feasible. This technique may provide both an attractive way to reduce injury to the anterior neck tissue and a method for ideal cosmetic effect.
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