经脐单部位腹腔镜在小儿嵌顿性腹股沟斜疝中的手术探讨  

Study on Operation of Transumbilical Single-site Laparoscopic Surgery in Children with Strangulated Inguinal Hernia

作　　者：游志恒[1] 席红卫[1] 

机构地区：[1]山西省儿童医院普外科,山西太原030013

出　　处：《中外医疗》2017年第19期96-98,共3页China & Foreign Medical Treatment

摘　　要：目的探讨经脐单部位腹腔镜在小儿嵌顿性腹股沟斜疝手术治疗中的应用。方法分析该院从2014年6月—2016年6月收治的32例小儿嵌顿性腹股沟斜疝。该组32例中男孩29例,女孩3例。右侧嵌顿性斜疝27例,左侧嵌顿性斜疝5例。经脐窝右侧缘5 mm切口,放置Trocar,内置腹腔镜,观察疝内容物,腹腔镜监视下手法复位。经脐窝左侧置Trocar,进入持针器,由患侧腹股沟区刺入2-0带线缝合针,缝合内环口处关闭腹膜。如对侧存在隐匿性腹股沟斜疝,同时缝合对侧内环口。结果所有患儿均顺利完成腹腔镜下手术,手术时间15~38 min,术中无中转传统开放手术。术后无阴囊血肿、水肿发生。术中有1例疝内容物为小肠,手法复位后小肠浆膜撕裂,腹腔镜下间断缝合浆肌层。术后随访5个月~2年,无复发。结论经脐单部位腹腔镜下嵌顿疝手法复位,内环口缝扎术治疗小儿腹股沟嵌顿疝是一种有效可行的治疗方法,术后疗效满意,无复发。术后腹壁无可见手术瘢痕,切口美观。Objective To study the application of transumbilical single-site laparoscopic surgery in children with strangulated inguinal hernia. Methods 32 cases of children with strangulated inguinal hernia admitted and treated in our hospital from June 2014 to June 2016 were selected including 29 cases of males and 3 cases of females, and 27 cases with right incarcerated oblique inguinal hernia and 5 cases with left incarcerated oblique inguinal hernia, and the Trocar was placed by the umbilicus margo dexter 5 mmincision, and the hernia content was observed and the 2-0 suture needle with line was penetrated by the inguinal region of affected sides. Results All children had successfully finished the laparoscopic surgery,and the operation time was 15~38 min, and no one was converted to the traditional open surgery in operation, and there was no occurrence of hematoma of the scrotum and edema after surgery, and there was 1 case whose hernia content was small intestine, and the patient was followed up for 5 months to 2 years, and no recurrence. Conclusion The transumbilical single-site laparoscopic surgery in children with strangulated inguinal hernia is an effective and feasible method and the curative effect is satisfactory after operation without recurrence, and there is no operative scar in abdominal wall after surgery,and the incision is beautiful.

关 键 词：小儿 嵌顿性斜疝 腹腔镜 

分 类 号：R574[医药卫生—消化系统]