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1、经脐单孔腹腔镜肝脏手术TransumbilicalSingle-inscionLaparoscopicHepatoectomyNOTES对NOTES技术的探索与研究始于1998年,当时美国5所大学的有关专家组成了一个名为阿波罗的小组进行NOTES研究。正式提出了NOTES这一概念。迄今为止,NOTES有经胃、直肠、阴道、膀胱和脐等多条途径。脐是身体上惟一与生俱来的瘢痕。因脐部皮肤皱褶可以遮盖切口,从而达到无瘢痕手术的目的。TheNOTEStechnologyexplorationandresearchbeganin1998,atthattimeTheUnitedS
2、tates5UniversityofexpertscomposedaAppollo.TheNOTESstudygroup.ThegroupwasfirstcarriedoutbytheGastricapproachforendoscopicoperation,andformallyputforwardtheconceptofNOTES.Sofar,NOTEShasthestomach,rectum,vagina,bladderandumbilicalAndmanyotherways,differentpartsoftheoperationthroughthehol
3、lowviscerapunctureSitesvary.TheumbilicusisbodyonlybornwithScar.Withumbilicalfoldsofskinincisioncancover,soastoachieveThepurposeofoperationwithoutscar.经脐单孔腹腔镜肝切除术自1991年Reich等实施了世界首例腹腔镜肝切除术以来，随着腹腔镜技术的不断成熟，腹腔镜技术在肝脏疾病中的应用已逐步得到认可和推广。该器官的单孔腹腔镜手术较为复杂，手术难度大并且其受制于手术难度及手术器械的发展国内外鲜有报道。单切口腹腔镜肝脏手术
4、我科已于2010年开展共10例，国内301医院刘荣有12例报道，国外日本，法国各有1例零星报道。Since1991,Reichperformedtheworld'sfirstlaparoscopichepatectomy,laparoscopictechnologycontinuestomature,thelaparoscopictechniqueinliverdiseaseshasbeengraduallyrecognizedandpromotion.Theorgansofthesingleportlaparoscopicoperationiscomplex,o
5、perationdifficultyisgreatanditssubjecttotheoperationdifficultyandoperationdevicedevelopmentathomeandabroadhasbeenrarelyreported.经脐单孔腹腔镜肝切除术Ourdepartmentcompletednearly1000casesofsingleportlaparoscopicoperation.Theliverisrichinbileductandvascularparenchymaorgan,livertumors,stonesinintr
6、ahepaticbileductinducedhepaticatrophyishepaticresectionoperationindications,laparoscopicliveroperationasoperationequipmentdevelopmenthasobtainedtheconsiderabledevelopment,intraoperativeclosedcuttingdeviceapplications,woundhemostasistoolapplicationsalwaysconsideredendoscopicoperationar
7、eaofliveroperationbecomespossible,andhasbeenprovedinpractice.我科累计完成单孔腹腔镜手术千余例。肝脏是富含胆管及血管的实质性脏器，肝脏的良恶性肿瘤、肝内胆管结石诱发的肝脏萎缩等是肝切除手术适应症，腹腔镜下的肝脏手术随着手术器械的发展已经得到了长足的发展，术中切割闭合器的应用，创面止血工具的应用将一向被认为腔镜手术禁区的肝脏手术变为可能。经脐单孔腹腔镜肝切除术Operationitselfdoesnotgivepatientsmoreexcessrisk,intheimplementationofunfav
8、orabl
