一孔法腹腔镜手术治疗小儿嵌顿性腹股沟斜疝

One hole minilaparoscope operation to treat the incarcerated indirect inguinal hernia in children

目的介绍一孔法腹腔镜下疝内容物还纳、疝囊高位结扎的手术方法,探讨治疗小儿嵌顿性腹股沟斜疝的新术式。方法对30例嵌顿性腹股沟斜疝患儿于全身麻醉下建立人工气腹,置入腹腔镜,于患侧内环口体表投影处作1.5mm切口,刺入带线针,在腹腔镜监视下完成疝内容物手法复位、疝囊高位结扎术。结果全组平均手术时间16.5min(5～50min)。平均住院时间3.6d(1～8d)。手术均顺利完成,无嵌顿物坏死、嵌顿物切除及中转开腹病例。患儿术后疼痛轻,恢复快,腹部无疤痕。全组随访2～16个月,无阴囊水肿、睾丸萎缩等并发症,无1例复发。结论一孔法腹腔镜下疝内容物还纳、疝囊高位结扎术治疗小儿嵌顿性腹股沟斜疝疗效可靠,安全、美观,值得临床推广应用。

Objective To introduce the clinical application of one hole minilaparoscopie operation, to explore a new method of treating the incarcerated indirect inguinal hernia in children. Methods One hole minilaparoscopic operation applied to treat the 30 cases of incarcerated indirect inguinal hernia （male 26, female 4）age from 18 days to 8 years. 7 cases were left side incareerated inguinal hernia, 11 cases were right side and 12 cases were hilateral. Results All eases recovered without any complication.Operation persistent time was from 5min to 50min,average 16.5 min.Hospitalization time was from ld to 8d, average 3.6 d,Pain remission,rapid recovery after the operation,healing good and without abdominal scar, These patients were followed up for 2 months to 16 months, never one case occurred relapse.Scrotum hematoma,atrophy of testis etc complications were no seen. Conclusions One hole minilaparoscopic operation is salve and mieroinvasive. It is a useful microinvasive procedure in the treatment of incarcerated inguinal hernia for children,so it is worth spread in clinic.