总体来说,NOTES技术利用人体天然的腔道,避免了体表的可见手术切口,具有良好的前景,但是NOTES需要特殊的设备,而且目前缺少大宗的病例报道,其推广应用受到一定的限制。而二孔法腹腔镜技术一般不需要特殊的设备,采用现有的腹腔镜设备即可进行,研究证明[9]:相对于四孔及三孔法腹腔镜胆囊切除术,二孔法腹腔镜胆囊切除术同样安全,而且手术切口的外观更为美观,术后疼痛更轻。而二孔法针式腹腔镜胆囊切除术较二孔法腹腔镜胆囊切除术优势更为明显[8]。相对于Lee等的方法,我们剑突下的切口更小(2 mm),术后更为美观。
针式二孔法腹腔镜胆囊切除术是在标准腹腔镜胆囊切除术的基础上发展而来的,是对标准手术的一个补充,选择合适的病例,与四孔及三孔腹腔镜胆囊切除术相比同样安全可靠,而且体表可见手术切口小,具有良好的美容效果,值得在临床推广。
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