单部位腹腔镜辅助下经脐孔切除小儿腹部囊肿  被引量:10

Single-site laparoscopic-assisted excision of abdominal cysts in infants using umbilical laparoscopic port incision

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作  者:王业波[1] 李炳 

机构地区:[1]南京医科大学附属淮安第一医院肝胆外科,江苏淮安223300 [2]江苏省淮安市妇女儿童医院小儿外科,江苏淮安223002

出  处:《中国内镜杂志》2013年第1期77-80,共4页China Journal of Endoscopy

基  金:国家十一五科技支撑计划课题(No.2006BA105A06)

摘  要:目的探讨单部位腹腔镜辅助下经脐孔小切口成功切除小儿腹部囊性肿块的优点及可行性。方法 2010年3月~2012年3月利用经脐单部位腹腔镜辅助下经脐小切口切除小儿腹部囊肿共13例。其中新生儿6例,小婴儿1例(35d),9个月~11岁6例。均经脐部置入腹腔镜,明确诊断后脐轮下缘切开3~5mm,置入穿刺针,抽吸囊肿内液体后,经脐孔切口将囊肿提至腹壁外完成囊肿切除手术。小肠重复畸形患儿则经腹腔镜诊断后直接经稍扩大的脐孔提至腹腔外完成肠重复畸形切除术。结果该组患儿13例,12例在单部位腹腔镜辅助下经脐孔切口完成囊肿切除手术,该手术方法简单,手术过程顺利,其中1例为28个月男性患儿,拟行腹腔镜腹股沟斜疝修补术,术中诊断合并大网膜囊肿,同时行大网膜切除术,1例11岁患儿为侏儒症,右侧卵巢囊肿,左侧卵巢囊肿蒂扭转,沿脐部纵切口上下延长至切口长达5cm,完成双侧卵巢囊肿切除术。结论单部位腹腔镜辅助经脐孔小切口切除腹腔囊肿手术创伤小,技术要求简单。该术式将腹腔镜技术和体表外科手术相结合,经脐切口完成囊肿切除手术,特别适用于新生儿和婴儿。【Objective】The objective of this article was to summarize our experiences, advantages and feasibility with single-site laparoscopic-assisted excision of abdominal cyst in infants using umbilical laparoscopic port incision. 【Methods】Between March 2010 and March 2012, single-site laparoscopic-assisted excision using umbilical laparoscopic port incision was performed in 13 infants. Among these patients, 6 were neonates, 1 was in early infancy (35 days), and 6 were 9 months^11 years. Laparoscopic exploration was performed in all the cases by transumbilical procedure. Once the diagnoses were definitively confirmed, 3~5 mm small incision was made inferior umbilical border, a needle was inserted through the incision and abdominal wall, under the direct laparoscopic vision, the needle was inserted into the wall of the cyst and aspiration is accomplished by suction until the cyst was completely collapsed and became floppy. A forceps was introduced through the incision, the floppy wall of the cyst was held, the two incisions were connected and the cyst wall was gradually exteriorized through the umbilical port incision, and the cyst excision was performed. The intestinal duplication was also excised extra corporally.【Results】Overall 13 cases were performed by the procedure, 12 cases were accomplished with single-site laparoscopic-assisted excision. The technique was simple and the operation was accomplished smoothly.1 case was a 28 months boy, who was ready to perform herniorrhaphy, omental cyst was diagnosed by laparoscopy and excision was performed in the same time. 1 infant was a girl of dwarf (11 years old) with bilateral ovarian cyst and right torsed, the longitudinal umbilical incision was elongated to about 5 cm, bilateral cyst excision was accomplished.【Conclusion】This proposed mini-invasive technique using the umbilical incision proved to be less invasive, easier, and less technically demanding than the classic laparoscopic approach. It is a relatively simple procedure that combines laparos

关 键 词:单部位腹腔镜 腹部囊肿 小儿 

分 类 号:R726[医药卫生—儿科]

 

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