经脐部单孔腹腔镜治疗小儿腹股沟斜疝的临床应用

Clinical application of single-port trans-umbilical laparoscope to treatment of children with oblique inguinal hernia

目的探讨经脐部自然通路单孔腹腔镜手术治疗小儿腹股沟斜疝的可行性与安全性。方法使用微型腹腔镜,配合自制的针形缝合器,施行荷包缝合内环口与疝囊高位结扎术,治疗小儿腹股沟斜疝。对我科采用此方法收治的63例腹股沟斜疝患儿(年龄10个月～14岁)的相关临床资料进行分析,分别是单侧疝47例,双侧疝16例,其中有隐形疝10例。结果 63例均成功治愈,无中转开腹;单侧疝手术时间9～15 min,平均约13 min,双侧疝手术时间26～31 min、平均约28 min;术后未发生严重阴囊水肿、感染、睾丸萎缩、明显疼痛等并发症;住院2～4 d,平均3.5 d;术后随访3～12个月,未见疝复发等。结论经脐部自然通路单孔腹腔镜治疗小儿腹股沟斜疝可行、安全、有效,且微创美观、手术操作简便,值得推广。

Objective To explore the feasibility and safety of single-port trans-umbilical laparoscope for the treatment of children with oblique inguinal hernia.Methods Mini-laparoscope,self-made spiculiform stitching instrument,purse-string suture of internal ring and high ligation of hernial sac were used in the treatment.The clinical data of 63 children with oblique inguinal hernia receiving that treatment in our department（aged from 10 months to 14 years）were compared and analyzed.Among them,there were 47 cases of unilateral hernia and 16 cases of bilateral hernia,in which 10 cases were latent hernia.Results All 63 patients were successfully cured with no conversion to the open approach.The time of unilateral hernia operation was 9 to 15 min,and averaged 13 min.The time of bilateral hernia was 26 to 31 min and averaged 28 min.After the operation,no complications occurred,such as scrotum edema,infection,testicular atrophy and obvious aches.The length of stay was 2-4 d and averaged 3.5 d.No recurrence was found during 3-12 months of follow-up after the operation.Conclusion Single-port trans-umbilical laparoscope is feasible,safe and effective,which should be promoted clinically.