经脐双通道微型腹腔镜手术治疗儿童腹股沟斜疝

Trans-navel dual channel micro-laparoscopic in treating inguinal hernia in children

目的探讨经脐双孔通道径路用微型腹腔镜手术治疗小儿腹股沟斜疝的临床效果。方法脐缘左右侧皱褶处分别戮孔置入微型腹腔镜和操作钳,内环口体表投影处剌入带线雪撬针,器械钳配合下超高位缝合关闭疝囊和修补内环。体外打结,线结埋在皮下。结果治疗小儿腹股沟斜疝164例,单侧139例,双侧25例。单侧疝手术时间10～15 min(平均12 min),双侧疝22 min。无阴囊血肿和感染,平均住院时间2.5 d。随访1～12个月,脐缘皱褶内瘢痕线状很难辨出。无疝复发、肠粘连、睾丸萎缩和医源性隐睾。结论经脐双通道行微型腹腔镜手术治疗小儿腹股沟斜疝操作简单,损伤小,疗效确切,术后恢复快,很难辨认出手术戳口瘢痕,更具微创性,美容效果可满足腹壁无疤痕化手术的要求,值得临床推广。

Objective To study the Clinical effect of trans - navel dual - channel micro-laparoscopic in treating inguinal hernia in children. Methods To puncture holes both in left and right sides of umbilical. Placing in micro-laparoseopic and Clamp. To puncture on the surface of inner ring with sled needle belt line, and then to ligate the hernia sac in the high bit and repair the inner ring with the help of clamps, finally to tie a knot in vitro. Results 164 cases of inguinal hernia （ 139 cases of unilateral, 25 cases of bilateral） were treated by this method. The operation time was 10 to15 minutes in unilateral hernia patients, and 22 minutes in bilateral hernia cases. None of the patients suffered trom scrota1 hematoma or infection. The average length of hospital stay was 2.5 days. All the children were followed up from 1 to12 months. The scar in the umbilical edge was difficult to distinguish. None of the patients suffered from hernia recurrence, adhesions, testicular atrophy, or iatrogenic cryptorchidism. Conclusions The technology of trans-navel dual channel micro-laparoscopie is simple, effective, safe and quick recovery in treating inguinal hernia in children.