经脐腹腔镜联合针式抓钳在小儿疝囊高位结扎术中的应用

High Ligation of Hernia Sac in Children by Using Trans-umbilical Laparoscopy and Needle Type Grasping Forceps

目的探讨经脐腹腔镜联合针式抓钳在小儿疝囊高位结扎术中的价值。方法我院2020年1~9月完成21例经脐腹腔镜联合针式抓钳小儿疝囊高位结扎术,经脐建立腔镜观察孔,置入针式抓钳,在针式抓钳辅助下在疝内环口腹膜前钩线1圈并结扎。结果21例均在全麻下完成经脐腹腔镜联合针式抓钳小儿疝囊高位结扎术。手术时间单侧(34.8±14.8)min,双侧(52.2±6.3)min。1例术中出现精索血管出血;1例术后出现发热。住院(3.7±1.0)d。住院费用(5796.0±729.5)元。21例随访1~8个月,中位数3个月,无腹股沟疝复发。结论经脐腹腔镜联合针式抓钳小儿疝囊高位结扎术安全可行,切口美观,创伤小,对技术及器械要求低,值得临床应用。

Objective To explore the value of trans-umbilical laparoscopy and needle type grasping forceps used for high ligation of hernia sac in children.Methods A retrospective analysis was made on clinical data of 21 children cases of high ligation of hernia sac by using trans-umbilical laparoscopy and needle type grasping forceps from January 2020 to September 2020.The endoscopic observation holes were established through the umbilicus,and the needle grasping forceps were inserted.Under the assistance of needle type grasping forceps,the inner ring of the hernia was ligated one circle before the peritoneum.Results All the 21 patients underwent high ligation of hernia sac using trans-umbilical laparoscopy and needle grasping forceps under the general anesthesia.The operation time was(34.8±14.8)min for unilateral and(52.2±6.3)min for bilateral.There were 1 case of bleeding in the spermatic vessels and 1 case of postoperative fever.The length of hospital stay was(3.7±1.0)days,and in-patient expenses were(5796.0±729.5)yuan.All the patients were followed up for 1-8 months(median,3 months)without inguinal hernia recurrence.Conclusions High ligation of hernia sac by using trans-umbilical laparoscopy and needle type grasping forceps is safe and reliable.It has advantages such as good cosmetic incision,minimal invasion and low requirement for technique and apparatus,which is worthy of clinic application.