摘要
目的:总结反复嵌顿的腹股沟斜疝婴儿行单孔腹腔镜疝囊高位结扎术的手术经验与临床体会。方法:回顾分析为55例腹股沟斜疝婴儿行单孔腹腔镜疝囊高位结扎术的临床资料,其中男53例,女2例,2～8个月;单侧41例(74.5%),双侧14例(25.5%)。结果:55例手术均顺利完成,无需另做切口。术后婴儿顺利恢复,第2天出院,并正常进食。术后1个月复查,脐部切口愈合良好,腹部无疤痕,治疗效果与美容效果均满意。随访1个月～3年,均无复发。结论:单孔腹腔镜疝囊高位结扎术治疗婴儿腹股沟斜疝快速、安全、疗效明显可靠、创伤小、康复快、美容效果好。因婴儿腹腔容量小,腹壁较薄,穿刺Trocar时应轻柔、稳妥。可在具备相应麻醉及手术条件的医院广泛开展。
Objective： To review the operative and clinical experience of single-port laparoscopic high ligation of hernial sac in infants with repeated incarcerated indirect inguinal hernia. Methods ： The clinical data of 55 infants who suffered from indirect inguinal hernia and underwent single-port laparoscopic high ligation of hernial sac were retrospectively analyzed （ male ： 53, female ： 2 ; age ： 2 months old-8 months old）. Among them,74.5% （41/55） had unilateral hernia and 25.5% （ 14/55 ） had bilateral hernia. 27 infants were admitted to our hospital with the chief complaint of incarcerated oblique inguinal hernia. All the infants had repeated incarcerated oblique inguinal hernia. After preoperative preparation, the infants were administrated with transumbilical laparoscopic high ligation of hernial sac via a single-port. General anesthesia used trachea cannula, endoscope was inserted through navel, and the CO2 pneumoperito- neum pressure was between 8 to 10 mmHg. Then,the state of ipsilateral inguinal hernia as well as the presence or absence of contralat- eral potential processus vaginalis was observed. A trans-inguinal hollow needle was introduced extraperitoneally and peri-orificially, and then the suture of trans-hollowness was placed to ligate the ipsilateral internal ring of hernia as well as the contralateral asymptomatic hernia. Results：All the 55 infants were operated successfully without any other supplementary instrument through additional incision, and recovered well after surgery. At the second day after surgery, all cases left hospital with normal food intake. They were re-valuated one month after-operation, the umbilical incision healed well and no scars were observed on abdomen. That showed good treatment effect and obvious cosmetic advantage. None recurrence had been observed during a follow-up of one month to three years. Conclusions ： Sin- gle-port laparoscopic high ligation of hernial sac for infants with indirect inguinal hernia is an option with short operative duration, safe- ty, convinced therapeutic effect, minimal invasiveness, rapid recovery and cosmetic result in infants. Because the abdominal capacity of infants is small, the abdominal wall is thin, the puncture operation should be gentle and safe. This technology is worth extensive promo- ting at hospitals which have the corresponding anesthesia and operation conditions.
出处
《腹腔镜外科杂志》
2013年第3期189-191,共3页
Journal of Laparoscopic Surgery
关键词
疝
腹股沟
疝修补术
单孔
腹腔镜检查
婴儿
Hernia, inguinal
Herniorrhaphy
Single-port
Laparoscopy
Infant
