腹腔镜下腹腔内疝囊高位结扎术的临床应用(附260例报告)

Laparoscopic High Ligation of Inguinal Hernia:Report of 260 Cases

目的探讨腹腔镜疝囊高位结扎术在儿童腹股沟斜疝中的应用。方法2006年2月-2008年2月，对260例腹股沟斜疝患儿施行腹腔镜疝囊高位结扎术。二孔法经腹腔内内环口缝扎，28例同时将脐正中襞（或脐内侧襞）与内环口周围的腹横筋膜缝扎，10例同时将腹横筋膜及腹内斜肌的弓状下缘与腹股沟韧带缝扎。结果260例手术均成功完成，无中转开放手术。单侧手术时间15～45min，平均22min。259例随访2～23个月，平均11．6月，无脐戳孔疝，无医源性隐睾及睾丸萎缩，无肠粘连梗阻等并发症；术后5个月复发1例（0．4％）。结论腹腔镜疝囊高位结扎术治疗儿童腹股沟斜疝创伤小，安全，有效，手术并发症少，有很好的应用前景。

Objective To study the efficacy and safety of laparoseopic high ligation of indirect inguinal hernia in children. Methods From February 2006 to February 2008, totally 260 children with indirect inguinal hernia underwent laparoscopic high ligation in our hospital. Two trocars were used to ligate the inner circle. Results The procedure was completed successfully in all of the cases. The mean operation time was 22 minutes （range, 15 -45 minutes）. A 2- to 23-month follow-up （mean 11.6 months） was achieved in 259 of the patients. During the period, no patient showed incisional hernia, iatrogenic cryptorchidism or atrophy of the testicles, or intestinal adhesion. One patient showed recurrent hernia in 5 months after the surgery （0. 4% ）. Conclusion Laparoseopic high ligation of indirect inguinal hernia is a minimally invasive, effective, and safe procedure for children.