针式腹腔镜治疗小儿腹股沟斜疝的临床应用

Laparoscopic herniotomy in children

目的 探讨针式腹腔镜治疗小儿腹股沟斜疝的可行性。方法 总结采用针式腹腔镜治疗 2 3例小儿腹股沟斜疝的手术方法及疗效。手术方法 :气管插管 ,静脉复合麻醉。人工气腹。于脐部进针式镜 ,脐左 (左侧疝 )或脐右 (右侧疝 )进针式操作钳 ,于内环口体表投影处进雪撬针。体外打结。术中检查和 /或治疗对侧可能存在的隐性疝。结果 术程均顺利。平均每侧手术时间 2 3.5min。术后 2～ 4d出院。未发现严重并发症 ,随诊未见疝复发。结论 本方法克服了标准腹腔镜切口大 ,与开放手术相比优势不明显的缺点 ,又保留了标准腹腔镜的所有优点 ,设计合理 ,操作简便 ,创伤小 ,患者易于接受 ,可在有条件的医院推广。

Objective To evaluate the efficacy of laparoscopic herniotomy in children with a diameter of 2mm scope. Methods Under general anaesthesia, pneumoperitoneum was created. The laparoscope was inserted via umbilicus. Ipsilateral instrument port was created. Herniotomy was accomplished with sledge needle and extracorporeal knotting. The heterolateral internal ring was explored and managed similarly if hernia was present. Results The operative procedure was uneventful, averaging 23.5 minutes in duration. The patients were discharged 2～4 days post operatively with no major complication or recurrence. Conclusion Laparoscopic herniotomy with 2 mm scope has smaller incisions and renders itself more acceptable by the parents