脐动脉索在腹腔镜全腹膜外腹股沟疝修补术中的解剖及意义

Anatomy and significance of cord of umbilical artery in laparoscopic total extraperitoneal herniorrhaphy

目的:探讨脐动脉索在腹腔镜全腹膜外腹股沟疝修补术(totally extraperitoneal,TEP)中的意义。方法:2016年1月至2016年6月为30例男性单侧腹股沟疝患者均行TEP,术中分离出脐动脉索结构,测量脐动脉索与输精管交汇处距内环的距离及脐动脉索的直径,对比分析左、右侧及不同年龄组间的差异。结果:30例均顺利完成TEP,术后随访9~16个月,无一例复发,术中均清晰解剖出脐动脉索结构。脐动脉索与输精管交汇点距内环的距离平均(5.75±0.42)cm,脐动脉索直径平均(0.44±0.1)cm,未发现脐动脉索位置存在较大个体差异,不同年龄组及双侧数据差异无统计学意义。结论:TEP术中脐动脉索可作为精索去腹壁化的一个标志,对于临床操作具有指导意义。

Objective： To investigate the significance of cord of umbilical artery in laparoscopic totally extraperitoneal（ TEP）herniorrhaphy. Methods： Thirty male patients with unilateral inguinal hernia underwent TEP treatment from Jan. 2016 to Jun. 2016.Their cord of umbilical arteries were exposed and examined during the operations by measuring the diameters of their cord of umbilical arteries and the distances from the junction of their cord of umbilical artery and ductus deferens to their inner rings. In addition,the measurements were further analyzed by comparing the differences between the left side and the right side of the patients,and among different age groups. Results： All the 30 TEP operations were successful. In the postoperative follow-up of 9 to 16 months,there was no recurrence. All the structure of cord of umbilical arteries were clearly exposed and recorded during the operations. The average distance from the junction of cord of umbilical artery and ductus deferens to inner ring was（ 5. 75 ± 0. 42） cm,and the average diameter of cord of umbilical arteries was（ 0. 44 ± 0. 1） cm. No significant differences were found on their anatomy of cord of umbilical arteries,nor between different sides or age groups. Conclusions： During the TEP operation,the cord of umbilical artery can be regarded as a sign for parietalization of the spermatic cord and provide guidance for clinical operation.