单孔腹腔镜监视下经阴囊入路睾丸固定术  

Transcrotai appoach orchiopexy under single-port laparoscope

作　　者：马亚贞[1] 李索林[1] 于增文[1] 李英超[1] 李萌[1] 孙驰[1] 

机构地区：[1]河北医科大学第二医院小儿外科,石家庄050000

出　　处：《中华小儿外科杂志》2013年第2期116-118,共3页Chinese Journal of Pediatric Surgery

基　　金：河北省医学适用技术跟踪项目（编号：GL2010-14）

摘　　要：目的探讨单孔腹腔镜监视下经阴囊人路睾丸固定术治疗高位腹股沟型隐睾症的可行性和效果。方法2010年8月至2011年7月，23例患儿的27侧高位腹股沟型睾丸在单孔腹腔镜辅助下经阴囊人路完成睾丸固定术，用组织钳通过阴囊横切口经外环进入腹股沟管或腹腔抓住睾丸拖出体外，从精索横断未闭鞘突游离睾丸固定在肉膜外；最后在腹腔镜监视下用自制双钩疝针经皮腹膜外关闭开放鞘突。结果所有27侧睾丸在腹腔镜监视下成功固定在阴囊。手术时间30-90min，没有手术并发症。随访8～20个月，睾丸均位于阴囊内无回缩、萎缩和腹股沟疝的发生。结论单孔腹腔镜监视下经阴囊腹股沟引降睾丸固定术安全、简便、有效，提供了极好的美容效果。Objective To investigate the feasibility and efficacy of transcrotal approach orchiopexy for high inguinal cryptorchidism under the laparoscopic vision through an umbilical port. Methods From August 2010 to July 2011,23 children with 27 undescended testes in the higher inguinal canal were encountered. Transcrotal access orchiopexy assisted by single-port laparoscopy via the umbilicus was performed. After a transverse incision was made on the scrotum, tissue forceps was inserted into the inguinal canal or abdominal cavity through the scrotum and the external ring, and then the testis was grasped and pulled through extraeorporeally. The processus vaginalis was separated off the cord structure to release the testis from cephalad retraction, the testis was fixed within the dartos pouch. Finally, under the laparoscopic guidance, the patent processus vaginalis was closed with a homemade two- hooked core endoneedle percutaneous extraperitoneally. Results All 27 testes were successfully fixed via transcrotat access under the laparoscopic guidance. The operative time was 30-90 minutes. There were no introperative complications. All of the testes maintained at intrascrotal position with no atrophy or recurrent inguinal hernia during a follow up of 8 to 20 months. Conclusions Transcrotal endoinguinal pull-through orchiopexy with single-port laparoscopy is a safe, effective and feasible procedure. It offers excellent cosmetic outcomes.

关 键 词：隐睾 腹腔镜 阴囊 睾丸固定术 

分 类 号：R726.9[医药卫生—儿科]