双钩套扎针辅助小儿单部位腹腔镜阑尾切除术

发布时间：2018-09-05 19:08

【摘要】：目的改良和介绍双钩套扎针辅助小儿单部位腹腔镜阑尾切除术。方法 2015年9月~2016年9月,对27例小儿非包裹性阑尾炎采用双钩套扎针辅助单部位腹腔镜阑尾切除术。经脐正中切口放置30°腹腔镜,脐旁切口放置操作钳,双钩套扎针钩挂结扎线经右下腹横纹穿刺,在同一穿刺点经腹壁分次带入结扎线,分别结扎阑尾根部和远端,结扎阑尾系膜,电钩离断并取出病变阑尾。结果 27例手术均获成功。手术时间25~45 min,(31.0±3.5)min。术后1~3 d恢复排气并进流食。术后住院3~6 d,平均4.5 d。经1~6个月随访,均无切口感染、粘连性肠梗阻、盆腔脓肿等并发症发生。结论双钩套扎针辅助小儿单部位腹腔镜阑尾切除术是一种有效的阑尾切除方法,不但保留了之前钩针辅助单孔腹腔镜阑尾切除术本身的安全、简便特性,而且降低手术配合难度和疲劳感,使操作更加灵活和流畅,为治疗非包裹性阑尾炎增添了一种术式选择。
[Abstract]:Objective to improve and introduce double hook and needle assisted laparoscopic appendectomy in children. Methods from September 2015 to September 2016, 27 cases of unencapsulated appendicitis in children were treated with double hook and needle to assist laparoscopic appendectomy. A 30 掳laparoscope was placed through the median umbilical incision, an operating forceps were placed in the periumbilical incision, a double hook sleeve hook ligation line was inserted through the right lower abdomen transverse stripe, and the ligation line was brought into the ligation line separately through the abdominal wall at the same puncture point to ligate the root of the appendix and the distal end of the appendix, respectively. Ligate the mesenteric membrane of the appendix, break off the electric hook and remove the diseased appendix. Results all the 27 cases were successfully operated. The operative time was 25 ~ 45 min, (31. 0 卤3. 5) min. The exhaust and intake were recovered 1 and 3 days after operation. Postoperative hospitalization was 3 ~ 6 days (mean 4.5 days). No incision infection, adhesive intestinal obstruction and pelvic abscess were observed after 1 ~ 6 months follow-up. Conclusion double hook and needle assisted laparoscopic appendectomy in children with single site is an effective appendectomy method, which not only preserves the safety and simplicity of single hole laparoscopic appendectomy, but also preserves the safety and convenience of previous laparoscopic appendectomy. It also reduces the difficulty of operation and fatigue, makes the operation more flexible and smooth, and adds a kind of operative choice for the treatment of unwrapped appendicitis.
【作者单位】：河北医科大学第二医院小儿外科;
【基金】：国家卫生与计划生育委员会重大公益性项目(201402007)
【分类号】：R726.5

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