单孔腹腔镜处理小儿鞘状突未闭的经验介绍

目的探讨用大圆针行经脐部单孔法腹腔镜下鞘状突高位结扎术治疗小儿腹股沟斜疝及鞘膜积液的临床价值。方法广州市番禺区钟村医院自2010年1月至2015年6月收治的32例腹股沟斜疝及鞘膜积液患儿进行手术治疗,患儿均在单孔腹腔镜监视下,使用大圆针完成高位缝合未闭的鞘状突,并对手术时间、手术出血量、手术并发症、复发率进行分析。结果 32例手术均在腹腔镜下顺利完成,手术时间为6.5~22.5 min,平均13.2min,术平均中出血量均小于5 mL。25例获得随访6~36月,平均21.6月,并未发现有并发症及复发病例。结论使用大圆针行单孔法腹腔镜高位缝合鞘状突治疗小儿腹股沟斜疝及鞘膜积液操作简便、创伤小、安全有效、术后恢复快、不留瘢痕,非常适合在基层医院开展。

Single-port laparoscopic surgery in the treatment for patent processus vaginalis in children

【Abstract】 Objective To discuss the clinical value of trans?umbilical single port laparoscopic surgery in the treatment for indirect inguinal hernia and hydrocele in children. Methods Thirty?two cases of children with indirect inguinal hernia and hydrocele of our hospital between Jan. 2010 and June 2015 were enrolled in this study. They were all treated by high ligation of patent processus vaginalis under laparoscope with knitting needle. To analyze the operation time, blood loss, postoperative complications and recurrence rate for all the children. Results All surgery was successful without any serious complications. Operation time was 6.5 to 22.5 min，mean time was 13.2 min. Bleeding volume during the operation was 0.5 to 5 mL，mean volume was 1.2 mL. 25 patients were followed?up 6 to 36 months，mean visit time was 21.6 months. There were no complications and recurrence in this study. Conclusion Laparoscopic high sac ligation for pediatric indirect inguinal hernia and hydrocele by trans?umbilical single?port methods is safe，effective，convenient，micro?invasive，which is worth of being generalized in primary hospitals.