经脐单部位腹腔镜鞘状突高位结扎术治疗小儿鞘膜积液

Trans-umbilical laparoscopic single-site surgery to repair hydrocele in children

目的：探讨经脐单部位腹腔镜鞘状突高位结扎术治疗小儿鞘膜积液的疗效。方法自2012年1月至2013年9月作者治疗鞘膜积液239例，其中男性236例，女性3例。年龄1～9．8岁，平均3．8岁。右侧116例，左侧103例，双侧14例，一侧鞘膜积液合并对侧腹股沟斜疝6例。经脐两侧切口放入5 mm Trocar 及3 mm 抓钳，经内环口投影处穿刺雪橇带线针进行鞘状突高位结扎术，对术中情况、术后疗效及手术并发症进行分析。结果239例中，238例腹腔镜下成功完成手术。术中探查均发现患侧鞘状突未闭。术前诊断单侧鞘膜积液，术中发现对侧鞘状突未闭占51．6％。对患侧及对侧未闭的鞘状突均予高位结扎。所有患儿恢复良好。随访6个月至1年半，均未见复发。结论经脐单部位腹腔镜鞘状突高位结扎术，手术操作简单，术后切口美观，疗效确切，值得推广。

Objetive To evaluate the effect of trans-umbilical laparoscopic single-site surgery in repai-ring hydrocele in children.Methods From January 2012 to September 2013,239 patients who with hydrocele were performed surgery to close the patent processus vaginalis.236 cases were boys,and 3 cases were girls, from 1 year to 9.8 years old,average 3.8 years old.116 were right-sided hydrocele,103 were left-sided,14 were bilateral,6 were one side with hydrocele and the other side with hernia.One 5mm and one 3mm trocar were inserted through two umbilical incision.The hydrocele sac orifice was closed by circuit suturing around the internal inguinal ring with a needle.The surgery effect and complications were evaluated.Results 238 cases completed surgery with laparoscope.All cases have the patent processus vaginalis.51 .6% cases of unilateral hydrocele were found with bilateral patent processus vaginalis.Neither recurrence nor other postoperative com-plication was encountered in six month to one and half year follow-up. Conclusions The procedure is simple and easy to be mastered.This method is effective and with good cosmetic result.So the procedure is worthy to use.