两孔经腹腔内内环口缝扎法腹腔镜手术治疗小儿腹股沟斜疝

Two port transabdominal nene ring suture operation by laparoscopy in the treatment of children with indirect inguinal hernia

目的探讨两孔经腹腔内内环口缝扎法腹腔镜手术治疗小儿腹股沟斜疝的方法,并总结其疗效。方法回顾性分析2005年1月至2012年6月利用两孔、经腹腔内内环口缝扎法腹腔镜手术治疗的小儿腹股沟斜疝1230例的临床资料。结果所有病例均用本术式治疗。对内环口横径≤0.5cm者行单纯疝囊高位结扎术,内环口横径>0.5cm者行内环口修补+单纯疝囊高位结扎术。手术时间:单侧单纯疝囊高位结扎10～25min,平均20min,双侧平均35min;单侧内环口修补+单纯疝囊高位结扎:30～50min,平均40min。双侧平均60min。术后复发13例(1.1%),阴囊肿胀积气29例,腹膜后局部血肿10例,无肠粘连、戳孔疝、脐疝等发生。结论两孔经腹腔内内环口缝扎法腹腔镜手术治疗小儿腹股沟斜疝安全、可行、可靠,具有修补确切、复发率低、损伤小、恢复快、无皮下异物感及瘘形成等特点,对巨大疝的修补尤有明显的优势,值得推广。

Objective To study the method and effect of two port transabdominal nene ring suture operation by laparoscopy in the treatment of children with indirect inguinal hernia. Methods The clinical data of 1230 children with indirect inguinal hernia who were treated with two port transabdominal nene ring suture operation by laparoscopy from January 2005 to June 2012 were retrospectively analyzed. The patients with inner mouth diameter ≤ 0.5cm were treated with only high ligation of hernial sac,patients with inner mouth diameter ＆gt;0.5cm were treated with inner repair and only high ligation of hernial sac . Results All the patient were treated with the operation method.The operation time of unilateral only high ligation of hernial sac was 10 to 25 min,the average time was 20 min,the average time of bilateral operation was 35 min,unilateral inner repair and only high ligation of hernial sac was 30 to 50 min,the average time was 40 min,average time of bilateral operation wer 60 min.13 cases （1.1%） were with postoperative recurrence ,29 cases were with scrotal swelling pneumatosis,10 cases were with retroperitoneal local hematoma,and there were no intestinal adhesion,hole of abdominal and umbilical hernia.Conclusions The two port transabdominal nene ring suture operation by laparoscopy in the treatment of children with indirect inguinal is safety,feasible and reliable,it has the characteristics of repair of the precise,low recurrence rate,small damage,fast recovery and no subcutaneous foreign body sensation and fistula,and it has obvious advantages for the repair of huge hernia,so it is worth promoting.