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FAQ
The application of single-port laparoscopy technology in the field of colorectal cancer has made significant progress, and many important results have been achieved in recent years.
Since single-port laparoscopy was first used in colorectal cancer surgery in 2009, it has gradually become an important surgical method in this field. This technology further reduces surgical trauma and cosmetic effects by reducing the number of surgical incisions, and has received widespread attention and application. For example, a 2017 study divided 152 patients with colorectal cancer into a single-port laparoscopic surgery treatment group and a standard laparoscopic surgery treatment group. The results showed that single-port laparoscopic surgery has similar clinical efficacy and safety.
The clinical application of single-port laparoscopy technology has also been widely verified. Studies have shown that single-port laparoscopic radical resection of colorectal cancer not only has an exact radical effect, but also significantly improves postoperative recovery speed and quality of life.
In order to standardize and promote single-port laparoscopic technology, the Colorectal Tumors Committee of the Chinese Medical Doctor Association established a single-port laparoscopy group and released the "Expert Consensus on Single-port Laparoscopic Colorectal Surgery (2019 Edition)", aiming to provide Provide guidance and reference for the standardized implementation of single-port laparoscopic colorectal surgery in China. In addition, many single-port laparoscopic surgery training courses have been held in China to further improve doctors' operating skills and experience.
Although single-port laparoscopic technology has made significant progress in colorectal cancer surgery, it still faces several challenges and limitations. Therefore, future research needs to further explore and improve this technology to achieve wider applications and better clinical results.
The application of single-port laparoscopy technology in the field of colorectal cancer has made significant progress, but it still needs to be continuously optimized and improved to meet more clinical needs.
The specific operating steps and technical requirements of single-port laparoscopy in colorectal cancer surgery are as follows:
Surgical incision: Single-port laparoscopic surgery usually selects the middle of the umbilicus as the only incision, and enters the abdominal cavity through this incision for surgical operations. This type of incision reduces surgical trauma, allowing for faster postoperative recovery and shorter hospital stay.
Instrument placement: A puncture port (surgical port) is inserted through the umbilical incision, and then the surgical instruments are inserted into the abdominal cavity through the port.
Surgical operation: The operation technique of single-port laparoscopic surgery is basically similar to that of traditional multi-port laparoscopic surgery, but special attention needs to be paid to the coordination of instruments and operating skills. Movement of surgical instruments within the abdominal cavity may be limited due to the chopstick effect.
skills requirement:
Instrument crowding and collision: Since there is only one incision, the space for placement and operation of surgical instruments is limited, and instrument crowding and collision are prone to occur.
Ergonomic difficulties: Ergonomic challenges need to be overcome during surgery to ensure effective operation of surgical instruments.
Lack of triangulation instruments: There is a lack of traditional triangulation instruments in single-port laparoscopic surgery, which places higher requirements on the accuracy of the surgery.
Surgical effect: Single-port laparoscopic surgery has the advantages of less trauma, better aesthetics, less damage, faster postoperative recovery, and shorter hospitalization time.
In recent years, significant progress has been made in comparative research on the effects of single-port laparoscopy and traditional laparoscopy in colorectal cancer surgery. The following are several recent research results:
The minimally invasive nature of single-port laparoscopic surgery: As a more minimally invasive surgical technique, single-port laparoscopic surgery has been widely used in various surgeries. Studies have shown that single-port laparoscopic surgery has certain advantages over traditional laparoscopic surgery in terms of perioperative conditions and mid-term oncological outcomes.
Randomized controlled trial: A randomized controlled trial showed no significant difference in efficacy between single-port laparoscopic radical colorectal surgery and conventional laparoscopic radical colorectal surgery, but single-port laparoscopic surgery may have better cosmetic results and fewer postoperative complications.
Natural orifice specimen extraction surgery (NOSES): NOSES is an emerging minimally invasive surgical method. Compared with traditional laparoscopic surgery, it has certain advantages and safety in intraoperative and postoperative indicators. However, there are currently few direct comparison studies on NOSES and single-port laparoscopic surgery.
Feasibility and Outcome Assessment: One study evaluated the feasibility and effectiveness of single-port laparoscopic radical resection of sigmoid and rectal cancer and showed that single-port laparoscopic surgery is feasible and comparable to multiport laparoscopic surgery in these surgeries. Has certain advantages.
Clinical comparative studies: Multiple studies have shown that laparoscopic surgery (including single-port and multi-port) has good feasibility and safety in the treatment of colorectal cancer, and its clinical efficacy is not significantly different from traditional laparotomy.
Study on patients with right-sided colon cancer: A study on the experience summary and efficacy observation of single-port laparoscopic surgery for patients with right-sided colon cancer shows that single-port laparoscopic surgery has good clinical effects in this type of surgery.
The application of single-port laparoscopy in colorectal cancer surgery is gradually increasing and has shown advantages over traditional laparoscopic surgery in some aspects.
To overcome the challenges and limitations of single-port laparoscopic technology in colorectal cancer surgery, we can start from the following aspects:
Therefore, it is key to improve doctors' operational level through systematic training and practice.
Optimize surgical instruments and technology: The development and use of more advanced surgical instruments can effectively solve the problem of limited operating space. For example, Peking Union Medical College Hospital invented a dedicated multi-access platform for single-port laparoscopy with a rotation function, which broke through the technical difficulties of single-port endoscopic suturing.
Reduce restrictions on surgical indications: Although single-port laparoscopic surgery has many advantages, it is not widely used in clinical practice due to its difficulty in operation. Through research and exploration, its scope of indications will be gradually expanded so that it can be applied to more patients.
Accumulating more data through more clinical studies will help verify its efficacy and safety.
Pay attention to the management of postoperative complications: Due to the particularity of single-port laparoscopic surgery, the risk of postoperative complications may increase. Therefore, it is necessary to strengthen the management and preventive measures of postoperative complications.
The main guiding principles and recommendations put forward in the "Expert Consensus on Single-port Laparoscopic Colorectal Surgery (2019 Edition)" include the following points:
Standardized implementation: In order to further standardize the implementation and development of single-port laparoscopic colorectal surgery, many domestic experts who perform single-port laparoscopic colorectal surgery are invited to compile this consensus.
Promote healthy development: By writing a consensus, we aim to promote the standardized, healthy and orderly development of single-port laparoscopic colorectal surgery.
Lack of high-level research: It is pointed out that although single-port laparoscopic colorectal surgery has been performed more and more in recent years, there is still a lack of high-level prospective randomized controlled research, and many issues need to be discussed and standardized.
In colorectal cancer surgery, the future development trends and potential innovations of single-port laparoscopic technology mainly include the following aspects:
Robot-assisted surgery: With the continuous advancement of minimally invasive surgical technology, single-port surgical robot-assisted surgical operations have become a future development trend. The breakthrough of domestic surgical robots and their successive approvals for marketing have provided new possibilities for single-port laparoscopic technology. For example, the application of the da Vinci multiport surgical robot in single-port surgery has promoted the development of single-port surgery.
Technological innovation and series of device development: Through innovative means such as transurethral auxiliary technology, the effect and safety of single-port laparoscopic surgery can be further improved. For example, in urology, significant advantages have been achieved by utilizing the body's natural channels for single-port laparoscopic radical prostatectomy.
Application of artificial intelligence (AI): The introduction of artificial intelligence technology can further improve the accuracy and efficiency of single-port laparoscopic surgery. AI technology can help doctors better analyze intraoperative images and monitor surgical progress in real time, thereby improving the success rate and safety of surgery.
Modular technology and new methods: For example, in hepatobiliary surgery, modular single-port laparoscopic technology combined with "three-point method" gallbladder suspension technology greatly reduces the difficulty of the operation and improves the safety and repeatability of the operation.
Comprehensive application of multiple technologies: observing tumor cell growth and infiltration through frozen pathology, intraoperative magnetic resonance and other technologies can more comprehensively evaluate the surgical effect and ensure the accuracy of postoperative treatment.
The future development trend of single-port laparoscopic technology in colorectal cancer surgery mainly focuses on robot-assisted surgery, technological innovation, artificial intelligence application, modular technology and comprehensive application of multiple technologies.
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