腹腔镜治疗小儿疝及鞘膜积液180例报告

目的：探讨腹腔镜治疗小儿腹股沟斜疝及交通性鞘膜积液的新方法。方法：行腹腔镜手术治疗小儿腹股沟斜驰及交通性鞘膜积液180例，其中小儿腹股沟斜疝150例，右侧80例，左侧40例，双侧30例；单侧斜疝中20例有对侧隐性疝；交通性鞘膜积液30例，右侧20例，左侧10例。均在腹腔镜下行内环口荷包缝合高位结扎术＋积液抽出术。结果：手术时间单侧疝平均5-10min，双侧疝10～20min。术后平均1．5d出院，皮肤切口无需缝线。无并发症发生。随访6～24个月，平均12个月，未见复发。结论：腹腔镜下内环口高位结扎术＋积液抽出术具有安全有效、创伤小、无瘢痕、康复快、住院时间短、操作简便、无需特殊器械等优点，无阴囊感染、睾丸扭转及缺血坏死、切口感染、髂腹沟及髂腹下神经损伤、腹股沟区疼痛麻木等并发症发生，疗效满意。

Laparoscopic treatment of inguinal hernia and hydrocele of tunica vaginalis in children: a report of 180 cases

Objective:To explore a new method of laparoscopy in treatment of indirect inguinal hernia and the hydrocele of tunica vaginalis in children.Methods:One hundred and eighty cases with indirect inguinal hernia and the hydrocele of tunica vaginalis were treated by laparoscopic surgery.Among them,150 cases had indirect inguinal hernia(right:80 cases,left:40 cases,bilateral:30 cases),20 cases had contralateral latent hernia in the unilateral hernias,and 30 cases(right:20 cases,left:10 cases)with the hydrocele of tunica vaginalis.All patients underwent internal orifice high ligation with laparoscopy,and the hydrocele of tunica vaginalis was drawn out.Results:The average operative time was 5-10min in unilateral hernia and 10-20min in bilateral hernia.The mean postoperative hospitalization was 36h.Skin sutures were not required.All patients were followed-up for 6-24months(mean 12 months),and no complications and recurrence occurred.Conclusions:Laparoscopic high ligation surgery and removal of the hydrocele of tunica vaginalis is a simple,satisfactory,effective,and minimally invasive surgical method.It causes no infection in the wound cut,scrotum and testis,no nerve damage,no pain and numb in lower abdomen.