水分离双钩套扎针辅助单孔腹腔镜腹股沟疝腹膜外结扎术

发布时间：2018-05-23 06:56

本文选题：腹股沟疝 + 单孔　；参考：《中国微创外科杂志》2017年01期

【摘要】：目的探讨使用双钩套扎针腹膜外注水分离技术辅助单孔腹腔镜腹股沟疝内环结扎术的可行性与安全性。方法 2013年7月~2015年6月582例763侧小儿腹股沟疝经脐单孔腹腔镜监视下,将双钩套扎针钩挂结扎线经内环体表穿刺,一次穿刺腹壁保持进出线在同一路径,借助水分离技术环绕疝缺损腹膜外套扎内环。结果全部患儿均顺利完成单孔腹腔镜经皮穿刺腹膜外内环结扎术,其中401例行单侧内环结扎术,181例行双侧内环结扎术。48侧巨大疝钩挂同侧脐内侧韧带遮盖修补术,15例网膜粘连或滑动疝在脐旁置入另一操作钳辅助完成。单侧和双侧腹股沟疝手术时间分别为(10.6±2.2)min和(13.8±2.4)min。无切口感染、医源性隐睾或睾丸萎缩等并发症发生。574例随访6~30个月,平均9.6月,1例复发,2例鞘膜积液,3例线结肉芽肿形成。结论采用双钩套扎针注水分离技术辅助单孔腹腔镜腹膜外疝环结扎术是一种安全有效的简便方法,脐窝瘢痕隐蔽、美观,是治疗小儿腹股沟疝值得选择的技术。
[Abstract]:Objective to explore the feasibility and safety of using double hook and needle to separate the internal ring of inguinal hernia with single-hole laparoscopy. Methods from July 2013 to June 2015, 582 cases (763 sides) of inguinal hernia of children were monitored by umbilical single hole laparoscopy. The double hook sleeve hook and ligation line were punctured through the inner ring of body surface, and the abdominal wall of one time puncture was kept in the same path. The technique of water separation was used to surround the defect of hernia and to ligate the inner ring of the peritoneal coat. Results all the children were successfully treated with single hole laparoscopic percutaneous peritoneal internal ring ligation. 401 cases were treated with unilateral internal ring ligation and 181 cases with bilateral internal ring ligation. 48 sides of giant hernia hook were covered by the ipsilateral medial umbilical ligament. 15 cases of omentum adhesion or sliding hernia were placed in another operation forceps. The operative time of unilateral and bilateral inguinal hernia was 10.6 卤2.2)min and 13.8 卤2.4 min, respectively. No incision infection, iatrogenic cryptorchidism or testicular atrophy and other complications occurred in 574 cases, followed up for 6 ~ 30 months, with an average of 9. 6 months in 1 case with recurrence and 2 cases with hydrocele and 3 cases with linear nodular granuloma. Conclusion it is a safe, effective and simple method to apply double hook and needle injection separation technique to single hole laparoscopic ligation of extraperitoneal herniation ring. The umbilical fossa scar is concealed and beautiful. It is worth choosing to treat inguinal hernia in children.
【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公益性行业科研专项(项目编号:201402007)
【分类号】：R656.2

【相似文献】