改良单孔法腹腔镜手术治疗儿童腹股沟疝的应用体会

A modified single-port laparoscopic technique for the repair of indirect inguinal hernia in children

目的探讨改良单孔法腹腔镜手术治疗小儿斜疝的安全性及有效性。方法 2006年2月~2010年10月,对77例小儿腹股沟斜疝采用改良单孔法腹腔镜手术,经脐部置入3 mm或5 mm腹腔镜监视腹腔,在体外使用普通开放手术针持夹持大圆针,在缺损内环口体表刺入并带入4号丝线,在腹膜外环形高位缝扎内环口。结果 77例均手术成功。术中发现并同时处理对侧隐匿性斜疝22例（31.4%）。平均手术时间48例单侧疝13 min（7~19 min）,29例双侧疝21 min（14~31 min）。术后住院时间平均48 h（26~52 h）,未发现有脐戳孔疝、戳口处血肿、腹膜外气肿、阴囊血肿等并发症。35例获得随访6~36月,平均22.6月,无并发症及复发病例。结论改良单孔法腹腔镜手术治疗小儿斜疝安全、可靠,创伤少,效果好,容易学习掌握。

Objective To introduce a modified method of laparoscopic treatment for indirect inguinal hernia in children, evaluate its safety and efficacy. Methods During Feb. 2006 and Oct. 2010, 77 children with indirect inguinal hernia were treated by laparoscopic surgery. All patients underwent high ligation surgery with a modified one port laparoscopic technique： mainly performed by extraeorporeal suturing with an ordinary taper needle （1/2 Arc 11 ×34）. The clinical data were retrospectively analyze. Results All surgeries were successful without serious complications. During operation, contralateral occult indirect inguinal hernia were found and subsequently repaired in 22 cases（31.4%）. The mean of operative time was 13 mins （7-19 min） in 48 cases of unilateral hernia and 21 min （14-31 min） in 29 cases of bilateral hernia. The mean of postoperative hospital stay was 48 h （26-52 h）. ＇Fhirty-five patients were followed-up from 6 to 36 months, and mean followed-up time was 22.6 months. There were no complications and recurrence in this study. Coneluslon The modified single-port laparoscopic technique for the repair of indirect inguinal hernia in children is a safe and reliable procedure, with minor invasion and satisfied outcome. It is easy to be learned and performed.