经脐单一部位腹腔镜下9号针头腹膜外缝合治疗小儿斜疝  

Single-incision Laparoscopic Extraperitoneal Inguinal Hernia with a No.9 Needle in Children

作　　者：卢贤映[1] 戚士芹[1] 未德成[1] 黄河[1] 杨涌[1] 

机构地区：[1]安徽省立儿童医院普外科,合肥230051

出　　处：《中国微创外科杂志》2012年第10期914-916,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经脐单一部位腹腔镜下应用9号注射针头腹膜外缝合治疗小儿斜疝的可行性。方法 2011年3～10月对51例小儿斜疝横行切开脐孔皮肤约1.0 cm,开放式置入5 mm trocar后进镜,建立气腹后于切口内5 mm trocar旁盲穿置入3 mm trocar,置抓钳。9号针头内穿7号丝线,刺入内环口前壁腹膜外,先内侧后外侧腹膜外环形缝合内环口,腹腔内、皮下分别打结完成疝囊高位结扎。结果 51例手术均成功,8例术中发现对侧隐匿性斜疝。手术时间:32例单侧10～20 min,平均13 min;19例双侧20～35 min,平均24 min。无腹壁皮下气肿、阴囊肿胀等并发症。51例随访2～7个月,平均5个月,无复发。结论经脐单一部位腹腔镜下应用9号注射针头腹膜外缝合治疗小儿斜疝,器械简单,操作容易,效果确切,美容效果好,值得推广。Objective To evaluate the efficacy of single-incision laparoscopy with a No. 9 needle for extraperitoneal repair of inguinal hernia in children. Methods Totally 51 children with indreict inguinal hernia, who underwent laparoscopic repair in our hospital from March to October 2011, were enrolled into this study. Via a 1.0-cm transverse umbilicai incision, we placed a 5-mm trocar into the abdominal cavity, and then after pneumoperit0neum was made, a 3-mm trocar was inserted through the same incision next to the 5-mm trocar to set grasping forceps. A No. 9 needle with No. 7 silk suture was pierced into the anterior wall of the deep inguinal ring and then extraperitoneal piercing was performed first inside and then outside of the wall to the posterior wall of the deep inguinal ring. The inside and outside sutures were ligated intraperitoneally and subcutaneously to complete extraperitoneal high ligation of the hernia. Results The operation was successfully completed in all of the cases; in 8 of the cases, contra!ateral occult hernia was detected. The operation time rtlnged from 10 to 20 rain （mean, 13 rain） for unilateral procedures, and 20 to 35 min （mean, 24 min） for bilateral procedures. No abdominal subcutaneous emphysema or scrotal swelling occurred after the operation. The patients were followed up for 2 to 7 months（ mean,5 months）, during which no patients had recurrent hernia. Conclusions Single-incision laparoscopy with No. 9 needle is effective for indirect inguinal hernia. The procedure is simple, effective, minimal invasive with good cosmetic outcomes.

关 键 词：单一部位腹腔镜 腹股沟斜疝 小儿 

分 类 号：R726.5[医药卫生—儿科]