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首页> 外文期刊>Surgical Endoscopy >Providing more through less: current methods of retraction in SIMIS and NOTES cholecystectomy.
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Providing more through less: current methods of retraction in SIMIS and NOTES cholecystectomy.

机译：事半功倍：SIMIS和NOTES胆囊切除术的当前退缩方法。

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BACKGROUND: As the field of minimally invasive surgery continues to develop, surgeons are confronted with the challenge of performing conventional laparoscopic surgeries through fewer incisions while maintaining the same degree of safety and surgical efficiency. Most of these methods involve elimination of the ports previously designated for retraction. As a result, minimally invasive surgeons have been forced to develop minimally invasive and ingenious methods for providing adequate retraction for these procedures. Herein we present our experience using endoloops and internal retractors to provide retraction during Single Incision Minimally Invasive Surgery (SIMIS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) cholecystectomy. We also present a review of the alternative retraction methods currently being employed for these surgeries. METHODS: SIMIS was performed on 20 patients and NOTES was performed on 5 patients at our institution. Endoloops or internal retractors were used to provide retraction for all SIMIS procedures. Internal retractors provided retraction for all NOTES procedures. RESULTS: Successful cholecystectomy was accomplished in all cases. One SIMIS surgery required conversion to standard laparoscopy due to complex anatomy. There were no intraoperative complications. Although adequate retraction was accomplished in all cases, the internal retractors were found to provide superior and more versatile retraction compared to that of endoloops. CONCLUSION: Adequate retraction greatly simplifies SIMIS and NOTES surgery. Endograb internal retractors were easy to use and were found to provide optimal retraction and exposure during these procedures without complications.
机译：背景：随着微创手术领域的不断发展，外科医生面临的挑战是通过较少的切口进行常规的腹腔镜手术，同时保持相同程度的安全性和手术效率。这些方法大多数涉及取消先前指定的缩回端口。结果，微创外科医师被迫开发微创和巧妙的方法以为这些手术提供足够的牵开。在这里，我们介绍在单切口微创手术（SIMIS）和自然孔腔内镜手术（NOTES）胆囊切除术中使用内环和内部牵开器进行牵开的经验。我们还介绍了目前用于这些手术的替代性撤回方法。方法：我们机构对20例患者进行了SIMIS，对5例患者进行了NOTES。使用Endoloops或内部牵开器为所有SIMIS程序提供牵开。内部伸缩器为所有NOTES程序提供了伸缩性。结果：所有病例均成功完成了胆囊切除术。由于复杂的解剖，一项SIMIS手术需要转换为标准腹腔镜检查。没有术中并发症。尽管在所有情况下均能完成足够的缩回，但与内环相比，发现内部的缩回器可提供出众且更通用的缩回。结论：充分的回缩可大大简化SIMIS和NOTES手术。 Endograb内部牵开器易于使用，在这些手术过程中被发现可提供最佳的牵开和暴露程度，且无并发症。

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