导丝引导在经脐单孔腹腔镜下儿童腹膜外疝囊高位结扎术中的应用  

APPLICATION OF GUIDE WIRE IN TRANSUMBILICAL SINGLE-PORT LAPAROSCOPIC EXTRAPERITONEAL HIGH LIGATION OF HERNIA SAC IN CHILDREN

作　　者：耿磊[1] 丁国建[1] 徐晓亮[1] 孙帅 刘希杰[1] 郑步峰[1] 刘腾[1] 傅廷亮[1] GENG Lei;DING Guojian;XU Xiaoliang;SUN Shuai;LIU Xijie;ZHENG Bufeng;LIU Teng;FU Tingliang(Department of Pediatric Surgery,Binzhou Medical University Hospital,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院儿外科,山东滨州256603

出　　处：《精准医学杂志》2020年第1期76-78,83,共4页Journal of Precision Medicine

基　　金：滨州医学院科技重点计划基金(BY2012KJZD02)。

摘　　要：目的探讨使用导丝引导行经脐单孔腹腔镜下儿童腹膜外疝囊高位结扎术的可行性和疗效。方法选择2017年10月—2018年3月入住我院确诊的腹股沟斜疝患儿128例,行经脐单孔腹腔镜下腹膜外疝囊高位结扎术,采用导丝引导技术用硬膜外穿刺针带丝线经患侧内环口体表位置进行穿刺,使得两次穿刺在腹膜外同一路径环绕疝囊颈部,真正做到腹膜外疝囊高位结扎。结果全部患儿均顺利完成单孔腹腔镜经皮穿刺置线腹膜外疝囊高位结扎术,其中86例患儿行单侧手术,42例患儿行双侧手术。单侧和双侧腹股沟斜疝手术时间分别为(12.4±2.1)min和(20.3±3.7)min。无切口感染、医源性隐睾或睾丸萎缩等并发症发生。术后随访6个月无复发患儿。结论采用导丝引导技术行经脐单孔腹腔镜下腹膜外疝囊高位结扎术安全、有效、简便,脐窝瘢痕隐蔽、美观,值得推广。Objective To investigate the feasibility and efficacy of guide wire in transumbilical single-port laparoscopic extraperitoneal high ligation of hernia sac in children. Methods A total of 128 children who were admitted to our hospital from October 2017 to March 2018 and were diagnosed with indirect inguinal hernia were enrolled and treated with transumbilical single-port laparoscopic extraperitoneal high ligation of hernial sac. A guide wire was used for puncture at the body surface of the ipsilate-ral inner ring using an epidural needle with suture, which helped the needle and suture to surround the neck of the hernia sac via the same path and thus achieved extraperitoneal high ligation of hernia sac. Results Single-port laparoscopic transdermal puncture and extraperitoneal high ligation of hernia sac were successfully performed for all children, among whom 86 underwent unilateral surgery and 42 underwent bilateral surgery. The time of operation was(12.4±2.1) min for unilateral surgery and(20.3±3.7) min for bilateral surgery. There were no complications such as incision infection, iatrogenic cryptorchidism, and testicular atrophy. No recurrence was found after 6 months of follow-up. Conclusion Transumbilical single-port laparoscopic extraperitoneal high ligation of hernia sac with a guide wire is a safe, effective, and convenient technique in the treatment of inguinal hernia in children, with invisible scars at the umbilical fossa, and therefore, it holds promise for clinical application.

关 键 词：疝 腹股沟 腹腔镜检查 结扎术 单孔 导丝引导 腹膜外 儿童 

分 类 号：R726.578[医药卫生—儿科]