Operative experiences on transumbilical single incision laparoscopic cholecystectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To study the feasibility and safety of transumbilical single incision laparoscopic cholecystectomy.</p><p><b>METHODS</b>Eighty-two cases with gallbladder diseases were underwent with transumbilical single incision laparoscopic cholecystectomy. Some difficulties and countermeasure in operations were analyzed.</p><p><b>RESULTS</b>Nine in all patients were converted because of the surrounding inflammation of gallbladder, difficult to dissect in Calot's triangulation and variation of gallbladder artery. Of them, 6 cases converted to two-hole laparoscopic cholecystectomy and 3 cases to open operation. Other 73 cases were successfully operated with transumbilical single incision laparoscopic cholecystectomy. The success rate was 89.0%. The average operative duration was 48.4 min. The average operative blood loss was 20.8 ml. Patients returned to liquid food on the first day after operation. Hospital duration was 3 ~ 6 d. During 13.7 months of follow-up, there was no bile duct injury, large bleeding, incision infection, bile fistula and umbilical hernia. The incision healed well. The scar in umbilicus was concealing and difficult to be observed.</p><p><b>CONCLUSIONS</b>Transumbilical single incision laparoscopic cholecystectomy is safe and feasible. The difficulties in technique are easy to be broken through.</p>

Standardized skill of mastoscopic axillary lymph node dissection / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the standardized skill of mastoscopic axillary lymph node dissection (MALND).</p><p><b>METHODS</b>The clinical results and operation experiences of 473 mastoscopic lymph node dissections performed were analyzed.</p><p><b>RESULT</b>The operation time was 22 - 156 minutes with the average of 42. The operative bleeding was minimal. No case was converted to conventionally open operation because of the uncontrolled bleeding. Fourteen (4 - 38) lymph nodes were removed. There was no intra- or post-operative complication.</p><p><b>CONCLUSION</b>The special view of mastoscopic lymph node dissection makes operative dissection clear. The suitable procedure and standardization of the operative method can stride over the learning curve, so as to quicken the operation and avoid the operative complication.</p>