针式腹腔镜下Endoclose针法治疗小儿腹股沟疝

目的　探讨对小儿腹股沟疝微创、简易、有效的治疗方法。　方法　 10 2例 ,116个各类疝内环口。年龄 10月～ 14岁。利用针式腹腔镜探查腹腔内疝内环口 ,电凝烧灼疝囊内壁后 ,采用Endoclose针法修补各类腹股沟区的疝内环口。　结果　除 1例术后 4周复发外 ,余术后恢复良好。术后随访 (3～ 4 0 )月 ,无术后复发及其它不适。 3例因术中刺破精索周围的小血管导致精索周围血肿 ;8例术后出现阴囊水肿 ,无死亡病例。　结论　腹腔镜下Endoclose针法治疗小儿腹股沟疝安全、有效、操作简易、恢复快 ,美容效果好亦 ,适宜于复发性小儿疝。

Laparoscopic Repair of Inguinal Hernia for Children by Endoclose

Objective To study a simple effecfiue and minimally in vasihe mefhool for laparoscopyic inguinal hernias in children. Methods Internal inguinal ring was explored with needle-laparoscopy (2 7mm laparoscope,30 degrees).The hernial sac was cauferiled by electrocoagulation and the internal inguinal ring cauterization with Endoclose. Results The technique was applied in 102 children 10 months to 14 years with an average,5 6 years and 118 internal inguinal rings.one case had recurrence three weeks after operation,The others had no recurrence and postoperative discomfort.The longest follw-up period was 46 months (3-46M).Hematomol around the spermafic cord was seen,which was cansed by cuffing of sman blood vessels around the spermati cord.postoperative scrotum hydrocele,appcared in 8 cases who gradually recovered after 5-8 days and no death happeneda. Conclusions Laparoscopic inguinal herniorrhaphy by Endoclose has the advantages less postoperative discomfort and pain,reduced recovery time that allows earlier full activity,easier repair of a recurrent hernia,the ability to treat bilateral hernias concurrently,ligation of the hernia sac at the highest possible site,improved cosmesis,and decreased incidence of recurrence,and the operation is safe.