自制T型牵拉器联合超微创钳在单孔腹腔镜胆囊切除术中的临床应用OA

Objective To explore the application feasibility of self-made 0.2 mm T-shaped retractor and 1.98 mm ultra-minimally invasive forceps in single-incision laparoscopic cholecystectomy(SILC).Methods This study retrospectively collected the clinical data of 31 patients who underwent SILC at Jianyang People's Hospital(Sichuan Provience)between October and November,2024.During the operation of SILC,1.98 mm ultra-minimally invasive forceps were inserted at the xiphoid process,and 0.2 mm T-shaped retractor was placed at the intersection of the right anterior axillary line and the right costal arch to assist in completing the procedure.The following parameters were recorded:operation time(from umbilical port establishment to umbilical port closure),intraoperative blood loss,time of T-shaped retractor puncture and suspension,time of 1.98 mm ultra-minimally invasive forceps assembly and disassembly,time of postoperative hospitalization,incidence of postoperative complications(bile leakage,incisional hernia,etc.),patient satisfaction with the postoperative incision,and the recovery status of the ultra-minimally invasive port at 6 months after surgery.Results All 31 patients successfully underwent the SILC with the assistance of the 0.2 mm T-shaped retractor and the 1.98 mm ultra-minimally invasive forceps,with no case requiring conversion to an alternative procedure.The median operation time was 41.0(36.5,48.5)min,and the median intraoperative blood loss was 5.0(5.0,5.0)mL.All patients were discharged the day after surgery and expressed satisfaction with the cosmetic appearance of the incision.At 6 months after surgery,the incisions demonstrated excellent cosmetic outcome,with no occurrence of bile leakage or incisional hernia.Conclusion SILC assisted with the 0.2 mm T-shaped retractor and the 1.98 mm ultra-minimally invasive forceps can effectively improve the surgical field exposure,overcome the"chopstick effect",and enhance the procedural safety.The auxiliary instruments create minimal wounds,resulting in concealed postoperative scars and good cosmetic results.