探讨在泌尿外科上尿路疾病的后腹腔镜手术中，将良性大体积标本先在体内进行分块处理，然后在不延长切口的情况下将标本从放置套管的微创切口取出的可行性。

选取2023年1月至2024年12月期间收治的肾上腺良性病变、无功能肾（非肿瘤或结核导致）和肾错构瘤等需要行腹腔镜下病变切除手术的患者，按研究条件筛选共有15例患者纳入研究。手术选择背侧切口为标本取出通道，背侧皮肤切开后使用Hasson技术建立腹膜后腔并放置套管。按常规手术流程完成对肾上腺、肾错构瘤和无功能肾的病变组织的切除。在标本取出环节，先将标本置入"微创外科专用切除组织取出器"（简称微创标本袋），在标本袋内对标本进行分块处理。对分块后的标本，在不延长切口的情况下按标本质地的不同采用不同的取出策略。并对标本的取出时间进行对比分析。

所有病例在未延长切口的情况下，均顺利通过腹腔镜微创切口完成了标本的取出，标本微创取出率100%。按标本的取出时间排序为：肾错构瘤[9.52（8.35~10.69）min]、肾上腺髓样脂肪瘤[9.78（8.92~10.91）min]、肾上腺腺瘤[15.12（12.15~17.52）min]、肾上腺多发结节样增生[15.27（14.95~15.59）min]和无功能肾[23.31（21.87~24.57）min]。术后随访9~12个月，所有病例中无切口出血、感染和切口疝的发生。标本的取出时间一方面和标本的体积有关，另一方面和标本的质地有关。肾错构瘤和肾上腺髓样脂肪瘤的标本取出耗时最短，肾上腺腺瘤和肾上腺结节样增生标本的取出耗时居中。无功能肾标本的取出耗时最长。

对于上尿路的良性大体积标本，经过体内分块处理后，在无需延长切口的情况下可顺利通过腹腔镜的微创切口取出。该方法简单可行，方便临床开展。

To explore the feasibility of segmenting benign bulk specimens in vivo and then removing them from a minimally invasive incision without extending the incision during retroperitoneoscopic surgery for upper urinary tract diseases in Urology.

Patients with adrenal benign lesions, non-functional kidney (not caused by tumor or tuberculosis) and renal hamartoma requiring laparoscopic resection of the lesions were selected from January 2023 to December 2024, and a total of 15 patients were included in the study. The dorsal incision was selected as the sample extraction channel. After the dorsal skin incision, Hasson technique was used to establish the retroperitoneal cavity and place the cannula. The adrenal, renal hamartoma and nonfunctional renal lesions were removed according to the routine surgical procedures. In the process of specimen extraction, the specimen is first placed into the "minimally invasive surgery special excision tissue extraction device" (referred to as the bag), and the specimen is processed in sections in the bag. Different extraction strategies were adopted according to the texture of the specimens without extending the incision. The extraction time of specimens was compared and analyzed.

In all cases, specimens were successfully extracted through laparoscopic minimally invasive incision without extending the incision. The success rate of specimen removal through minimally invasive incisions is 100%. Ranked by the time of specimen removal, they were renal hamartoma [9.52 (8.35-10.69) min], adrenal medullary lipoma [9.78 (8.92-10.91) min], adrenal adenoma [15.12 (12.15-17.52) min], multiple nodular hyperplasia of the adrenal gland [15.27 (14.95-15.59) min], and non-functional kidney [23.31 (21.87-24.57) min]. The postoperative follow-up period was 9 to 12 months. No incision bleeding, infection or incisional hernia occurred in all cases. The extraction time of the specimen is related to the volume of the specimen on the one hand, and the texture of the specimen on the other hand. The extraction time of adrenal medullary lipoma and renal hamartoma was the shortest, and the extraction time of adrenal adenoma and adrenal nodular hyperplasia was the middle. The extraction time of non-functioning kidney specimens is the longest.

Benign bulk specimens of the upper urinary tract can be successfully removed through a minimally invasive laparoscopic incision without the need to extend the incision after in vivo segmentation. This method is convenient and feasible and worthy of clinical promotion.