腹腔镜下小儿疝囊高位结扎术58例临床价值探讨

目的 探讨应用腹壁缝合针腹腔镜下治疗小儿腹股沟斜疝的手术方法及手术效果,并对几个常见问题进行讨论.方法 用腹壁缝合针在腹腔镜下对58例腹股沟斜疝患儿施行疝囊高位结扎术.结果 本组2例近期复发,1例疝囊积液.手术时间10～30min,平均18min.2例近期复发者系11个月双胞胎双侧巨型疝合并脐疝患儿,1例再次腹腔镜下双重荷包结扎,1例行传统高位结扎术治愈.结论 应用腹腔镜技术治疗小儿腹股沟斜疝具有安全有效、简单快速、损伤小、无需缝线、不留疤痕等特点,优于传统高位结扎术,但应掌握好手术技巧、手术时机及麻醉方法,对于巨型疝患儿应慎重.

Clinical significance of high ligation of hernial sac of infant in laparoscope

Objective To study the operation for repairing oblique inguinal hernia of infant by suture needle in laparoscope and its effect,and to discuss the common questions.Methods To take the high ligation of hernial sac by abdominal wall suture needl in laparoscope for 58 oblique inguinal hernias of infant.Results In the group,2 cases recurred in near future and 1 case fluidified in hernial sac.The operation lasted from 10 min to 30 min(mean 18min).The 2 cases recurred was 11-month twins with double giant henias combined with umbilical hernia.The one was double wallet ligated in laparoscope again,the other acceptted the traditional high ligation.Conclusion The feature of repairing oblique inguinal hernia abdominal wall of infant by suture needle in laparoscope is safe,effective,simple,quick,few damage,sutureless and nonscar.It has an advantage compared with traditional high ligation,but requests operative technique,opportunity and anesthesia method,and would be careful with giant henia of infant.