腹腔镜下单通道腹膜外高位结扎术治疗小儿腹股沟疝

目的 探讨腹腔镜下单通道腹膜外高位结扎术治疗小儿腹股沟疝的手术效果。方法 回顾分析我科2015年6月至2016年5月采用腹腔镜下单通道腹膜外高位结扎术治疗的350例腹股沟疝患儿的临床资料。对手术方法、手术时间、术后并发症等进行分析。结果 350例患儿腹腔镜下单通道腹膜外高位结扎手术均顺利完成，单侧平均手术时间为（4.5±1.2）min，双侧为（8.0±1.2）min。所有患儿均于术后第1天出院，平均住院时间为（2.6±0.8）d。术后均无腹股沟区疼痛不适、阴囊血肿等。随访半年至1年，未见疝复发、线结排斥反应、睾丸萎缩等并发症发生。结论 腹腔镜下单通道腹膜外高位结扎术治疗小儿腹股沟疝经腹壁一次穿刺可保持穿刺针在同一穿刺隧道，避免结扎过多组织引起术后疼痛不适，并减少线结排斥反应，简便易行，值得临床推广应用。

Single channel laparoscopic extraperitoneal high ligation treating pediatric inguinal hernia

Objective To explore the feasibility of single channel laparoscopic extraperitoneal high ligation for pediatric inguinal hernia. Methods The clinical data of 350 patients with inguinal hernia, who underwent single channel laparoscopic extraperitoneal high ligation in our department from Jun. 2015 to May 2016, were analyzed retrospectively. The surgical methods, operation time and postoperative complications were analyzed. Results The surgery was completed successfully on 350 cases. The average operative time was (4.5±1.2) min in the unilateral inguinal hernia, and (8.0±1.2) min in the bilateral ones. All patients were discharged on the first day after surgery, and the average hospital stay was (2.6±0.8) days. No inguinal pain or scrotal hematoma occurred after surgery. During the follow-up of 6 months to 1 year, there were no complications such as hernia recurrence, line reaction or testicular atrophy. Conclusion Single channel laparoscopic extraperitoneal high ligation for pediatric inguinal hernia keeps the puncture needle in the same tunnel, which avoids the postoperative pain at the puncture point and reduces the line reaction. It is safe and feasible, and is worth recommending for clinical use.