脐孔“T”形切口在多孔及单孔腹腔镜子宫肌瘤剔除术中的临床应用

Clinical application of umbilical “T-shaped” incision in laparoscopic myomectomy

摘要:

目的 探讨脐孔“T”形切口应用于多孔及单孔腹腔镜子宫肌瘤剔除术在标本取出方面的优势。方法 回顾性分析2024年1月－2025年12月在该院采用脐孔“T”形切口行腹腔镜子宫肌瘤剔除术的358例（多孔腹腔镜225例，单孔腹腔镜133例）患者的临床资料，手术采用脐孔“T”形切口技术。纳入同期单横向切口组205例，单纵向切口组153例。比较3组患者取瘤时间和术后并发症。结果 采用脐孔“T”形切口的358例患者均顺利完成手术。“T”形切口组取瘤时间为（15.00±6.20）min，明显短于单横向切口组的（17.20±6.00）min和单纵向切口组的（18.40±12.00）min，差异有统计学意义（P < 0.05）。“T”形切口可利用周径（5.14 cm）较传统直线切口（3.14 cm）增加了63.69%。3组患者术后切口感染率及切口疝发生率比较，差异均无统计学意义（P > 0.05）。结论 脐孔“T”形切口通过改变切口构型，有效扩大了可利用空间，配合袋内手工分碎技术，可有效地缩短取瘤时间，有利于减少肿瘤播散，符合无瘤操作要求，且纵向切口隐蔽于脐窝内美容效果好，具有一定的临床应用价值。

Abstract:

Objective To evaluate the clinical value of the umbilical "T-shaped" incision technique in multi-port and single-port laparoscopic myomectomy for specimen retrieval.Methods A retrospective analysis was conducted on the clinical data of 358 patients (225 cases of multi-port laparoscopy and 133 cases of single-port laparoscopy) who underwent laparoscopic myomectomy through a “T -shaped” incision at the umbilical port in this hospital from January 2024 to December 2025, the “T-shaped” incision technique was performed. Results were compared with concurrent single transverse group (n = 205) and longitudinal incision group (n = 153).The tumor removal time and postoperative complications were compared among the three groups.Results All procedures with “T-shaped” incisions were completed successfully. The specimen retrieval time in the “T-shaped” group (15.00 ± 6.20) min was significantly shorter than the single transverse group (17.20 ± 6.00) min and the longitudinal incision group (18.40 ± 12.00) min, the difference was statistically significant (P < 0.05). The available circumference increased by 63.69% (5.14 cm vs 3.14 cm). No significant differences in wound infection or incisional hernia rates among groups.Conclusion The “T-shaped” incision at the umbilicus effectively expands the available space by altering the shape of the incision. Combined with the manual fragmentation technique within the bag, it can significantly shorten the time for tumor removal, which is beneficial for reducing tumor dissemination and meets the requirements of tumor-free operation. And the longitudinal incision is concealed within the navel depression, resulting in excellent cosmetic effects and having certain clinical application value.