改良单孔法腹腔镜手术治疗儿童腹股沟疝的应用体会

【摘要】 目的 探讨改良单孔法腹腔镜手术治疗小儿斜疝的安全性及有效性。方法 2006年2月~2010年10月,对77例小儿腹股沟斜疝采用改良单孔法腹腔镜手术,经脐部置入3 mm或5 mm腹腔镜监视腹腔,在体外使用普通开放手术针持夹持大圆针,在缺损内环口体表刺入并带入4号丝线,在腹膜外环形高位缝扎内环口。结果 77例均手术成功。术中发现并同时处理对侧隐匿性斜疝22例(31.4%)。平均手术时间48例单侧疝13 min(7~19 min),29例双侧疝21 min(14~31 min)。术后住院时间平均48 h(26~52 h),未发现有脐戳孔疝、戳口处血肿、腹膜外气肿、阴囊血肿等并发症。35例获得随访6~36月,平均22.6月,无并发症及复发病例。结论 改良单孔法腹腔镜手术治疗小儿斜疝安全、可靠,创伤少,效果好,容易学习掌握。

A modified single-port laparoscopic technique for the repair of indirect inguinal hernia in children

【Abstract】〓Objective〓To introduce a modified method of laparoscopic treatment for indirect inguinal hernia in children,.evaluate its safety and efficacy. Methods〓During Feb..2006 and Oct. 2010,.77 children with indirect inguinal hernia were treated by laparoscopic surgery..All patients underwent high ligation surgery with a modified one port laparoscopic technique:.mainly performed by extracorporeal suturing with an ordinary taper needle.(1/2 Arc 11×34)..The clinical data were retrospectively analyze. Results〓All surgeries were successful without serious complications..During operation,.contralateral occult indirect inguinal hernia were found and subsequently repaired in 22 cases(31.4%)..The mean of operative time was 13 mins (7-19 min) in 48 cases of unilateral hernia and 21 min.(14-31 min) in 29 cases of bilateral hernia. The mean of postoperative hospital stay was 48 h.(26-52 h). Thirty-five patients were followed-up from 6 to 36 months,.and mean followed-up time was 22.6 months. There were no complications and recurrence in this study. Conclusion〓The modified single-port laparoscopic technique for the repair of indirect inguinal hernia in children is a safe and reliable procedure,.with minor invasion and satisfied outcome. It is easy.to be learned and performed.