[1]刘嘉林,周汉新,余小舫,等.腹腔镜小儿腹股沟斜疝内环缝合联合疝囊高位结扎术[J].中国微创外科杂志,2006,06(2):139-141.
　Liu Jialin,Zhou Hanxin,Yu Xiaofang,et al.Laparoscopic closure of the internal ring and high ligation of the hernial sac in children with indirect inguinal hernia[J].Chinese Journal of Minimally Invasive Surgery,2006,06(2):139-141.
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腹腔镜小儿腹股沟斜疝内环缝合联合疝囊高位结扎术()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年2期
页码:
139-141
栏目:
出版日期:
2006-02-20

文章信息/Info

Title:
Laparoscopic closure of the internal ring and high ligation of the hernial sac in children with indirect inguinal hernia　
作者:
刘嘉林; 周汉新; 余小舫; 鲍世韵; 帅建; 李明岳; 毕建钢
暨南大学医学院第二附属医院肝胆外科,深圳,518020
Author(s):
Liu Jialin;  Zhou Hanxin;  Yu Xiaofang;  et al.
Department of Hepatobiliary Surgery, Second Affiliated Hospital of Jinan University Medical College, Shenzhen 518020, China
关键词:
小儿; 腹股沟斜疝; 腹腔镜疝修补术; 内环
Keywords:
Child; 　Indirect inguinal hernia; 　Laparoscopic herniorrhaphy; 　Internal ring
分类号:
R726.1
文献标志码:
A
摘要:
目的探讨腹腔镜小儿腹股沟斜疝内环缝合联合疝囊高位结扎术的可行性.方法2003年1月～2004年12月,我院采用腹腔镜小儿腹股沟斜疝内环缝合联合疝囊高位结扎术治疗小儿腹股沟斜疝21例.经脐置入5 mm 30.腹腔镜,明确患侧内环口及腹横筋膜悬韧带后脚(posterior crus,PC),在耻骨联合与脐孔的中点置入3 mm分离钳.于患侧内环口的体表投影处,用普通针持夹持3-0 prolene带线圆针刺入腹腔,穿过PC,分离钳夹住圆针反向经腹横肌弓状缘从内环口顶部穿出腹腔.剪掉圆针,Endoclose针夹带prolene线由内环口的体表投影处穿入腹壁至腹膜外层,先内后外,围绕内环口在腹膜外完成荷包缝合,线拉出体外后打结.结果21例均顺利完成手术.手术时间16～50 min,平均32.9 min.术后住院1～2d,术后恢复日常活动时间1～4 d,平均1.4 d.术后无出血、阴囊血肿及切口感染并发症.21例随访1～24个月,平均15个月,未见复发病例.结论腹腔镜小儿腹股沟斜疝内环缝合联合疝囊高位结扎术是具有解剖学基础的新术式,疗效确切,安全可行.
Abstract:
Objective　To discuss the feasibility of laparoscopic closure of the internal ring and high ligation of the hernial sac in children with indirect inguinalhernia.　M ethods　Laparoscopic closure of the internal ring and high ligation of the hernial sacwas conducted in 21 children with indirect inguinal from January 2003 to December 2004 in this hospita.l A 5-mm 30°laparoscope was introduced through the umbilicus. The internal ring and the posterior crus (PC) on the side of hernia were identified. A 3-mm dissection forcepswas placed on themidline between the umbilicus and pubic symphysis. At the skin projection of the internal ring on the side ofhernia, a round-tip needlewith 3-0 Prolene suture grasped by a regularneedle holderwas passed directly into the abdominal cavity to suture the posterior crus and then penetrate outof the abdomen via the roofof the internal ring through themusculoaponeurotic arch of the transversus abdominis. Then the Prolene suture was cut of,f and passed by using the Endoclose device into the extraperitoneal cavity at the skin projection of the internal ring. The dissection was continued from without outward around the sac to encircle the neck and an extracorporealhigh circumferential ligation of the sacwas finished.　Results　The operationwas successfully completed in all the 21 cases. The operating timewas 16~50 min (mean, 32. 9 min), the postoperative duration in hospitalwas 1~ 2 d, and the time to normal activity, 1~4 d (mean, 1. 4 d), respectively. No postoperative bleeding, hematoma of scrotum, or incisional infection occurred. Follow-up checkups in the 21 cases for 1~24 months (mean, 15 months) showed no recurrence.　 Conclusions　Laparoscopic closure of the internal ring and high ligation of the hernial sac is a nove,l feasible, reliable and effective herniorrhaphy for the treatment of pediatric indirect inguinal hernia.

参考文献/References:

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更新日期/Last Update: 2014-01-27