[1]唐睿 段光琦* 刘洁 朱庆华 马鸿龙 王啸 随帮志 徐旭东 陈进 晋志远.单孔腹腔镜下使用水分离微抓钳治疗小儿腹股沟斜疝512例经验总结[J].中国微创外科杂志,2021,01(9):782-786.
　Tang Rui,Duan Guangqi,Liu Jie,et al.Treatment of Indirect Inguinal Hernia With Singleport Laparoscopic Hydrodissection Minigrasping Forceps: Experience Summary of 512 Children[J].Chinese Journal of Minimally Invasive Surgery,2021,01(9):782-786.
点击复制

单孔腹腔镜下使用水分离微抓钳治疗小儿腹股沟斜疝512例经验总结()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年9期
页码:
782-786
栏目:
临床论著
出版日期:
2021-09-25

文章信息/Info

Title:
Treatment of Indirect Inguinal Hernia With Singleport Laparoscopic Hydrodissection Minigrasping Forceps: Experience Summary of 512 Children
作者:
唐睿 段光琦* 刘洁 朱庆华 马鸿龙 王啸 随帮志 徐旭东 陈进 晋志远
（皖南医学院弋矶山医院小儿外科，芜湖241001）
Author(s):
Tang Rui;  Duan Guangqi;  Liu Jie;  et al.
Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241001, China
关键词:
腹股沟斜疝; 单孔腹腔镜; 水分离
Keywords:
Indirect inguinal hernia; Singleport laparoscopy; Hydrodissection
文献标志码:
A
摘要:
目的探讨单孔腹腔镜下使用水分离微抓钳腹膜外穿刺高位结扎疝囊治疗小儿腹股沟斜疝的安全性、有效性及可操作性。方法2019年6月~2020年5月对512例患儿756侧小儿腹股沟斜疝在经脐单孔腹腔镜监视下，将水分离微抓钳钳夹结扎线经内环体表穿刺，一次穿刺腹壁保持进出线在同一路径，借助水分离技术环绕疝缺损腹膜外套扎内环。 结果术中发现对侧隐性鞘状突未闭202例，同期一并处理，共结扎756侧。单侧和双侧手术时间分别为（8.3±1.5）、（13.6±2.3）min；巨大疝（内环直径＞1.5 cm）85例，加强修补45例；合并精索鞘膜积液2例，圆韧带囊肿2例，内脏下移5例，增加1把水分离微抓钳辅助处理。486例术后随访3～12个月，平均4.2月，2例巨大疝复发，2例脐部感染，无睾丸高位、睾丸萎缩、鞘膜囊积液、皮下血肿及线结肉芽肿形成等并发症发生。 结论单孔腹腔镜监视下使用水分离微抓钳腹膜外穿刺，借助水分离技术辅助经皮内环结扎是一种安全有效的术式。
Abstract:
ObjectiveTo investigate the safety, effectiveness and operability of the use of hydrodissection minigrasping forceps for extraperitoneal puncture and high ligation of hernia sac in children with indirect inguinal hernia under singleport laparoscopic monitoring.MethodsFrom June 2019 to May 2020, the data of 512 children (756 sides) with indirect inguinal hernia treated in our hospital were analyzed retrospectively. Under the monitoring of transumbilical singleport laparoscopy, the hydrodissection minigrasping forceps were used to clamp the ligation line and puncture through the surface of the inner ring, and the inlet and outlet line should be kept in the same path. The internal ring orifice was absolutely lassoed extraperitoneally by suture under the assistance of hydrodissection.ResultsDuring the operation, 202 cases of the contralateral occult sheath process were found and treated at the same time with 756 sides ligated. The average operation time of unilateral and bilateral was (8.3±1.5) min and (136±2.3) min, respectively. There were 85 cases of giant hernia (internal diameter >1.5 cm) and 45 cases was enhanced repaired. There were 2 cases of hydrocele of spermatic cord, 2 cases of cyst of round ligament, and 5 cases of internal organs moving down. All these cases were treated with an additional use of hydrodissection minigrasping forceps. A total of 486 cases were followed up for 3-12 months, with an average of 4.2 months. There were 2 cases of giant hernia recurrence and 2 cases of umbilical infection. No complications such as testicular high position, testicular atrophy, hydrocele, subcutaneous hematoma or linear granuloma were noted.ConclusionUnder the monitoring of singleport laparoscopy, it is a safe and effective operation method to use hydrodissection technology by minigrasping forceps to perform percutaneous internal ring ligation.

参考文献/References:

[1]刘雪来,王文博,杨晓锋,等.水分离腹壁缝合器辅助单孔腹腔镜腹股沟斜疝内环结扎术.中国微创外科杂志,2019,19(5):415-417,425.
[2]Takehara H, Yakabe S, Kameoka K. Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions. J Pediatr Surg,2006,41(12):1999-2003.
[3]Chang YT, Wang JY, Lee JY, et al. Onetrocar laparoscopic transperitoneal closure of inguinal hernia in children. World J Surg,2008,32(11):2459-2463.
[4]李萌,李索林,于增文,等.单孔腹腔镜下改良双钩疝针经皮腹膜外结扎术治疗小儿腹股沟疝.中华小儿外科杂志,2012,33(12):916-919.
[5]Tatekawa Y. Laparoscopic extracorporeal ligation of hernia defects using an epidural needle and preperitoneal hydrodissection. J Endourol,2012,26(5):474-477.
[6]段光琦,张敏,管肖浩.初学小儿单孔腹腔镜下应用疝针行疝内环结扎术的难点及对策.中国微创外科杂志,2012,12(2):175-177.
[7]李索林,费川,张永婷,等.水分离双钩套扎针辅助单孔腹腔镜腹股沟疝腹膜外结扎术.中国微创外科杂志,2017,17(1):42-45,50.
[8]李宁,张文,周学锋,等.单纯经脐腹腔镜在小儿复杂性腹股沟斜疝中的应用.中华小儿外科杂志,2012,33(10):751-753.
[9]钟红继,王复然,陈易.腹腔镜对侧鞘状突探查阴性后发生的对侧腹股沟斜疝报告.中华小儿外科杂志,2014,35(5):393-394.
[10]段永福,赵成鹏,周晓波,等.腹腔镜与传统手术治疗小儿腹股沟斜疝的对比研究.中国微创外科杂志,2017,17(3):234-236.
[11]费川,张永婷,李索林,等.单孔腹腔镜双钩疝针内环结扎并脐内侧襞遮盖术.中华腔镜外科杂志:电子版,2016,9(5):277-280.
[12]崔钊,鲁莹,李秋琳,等.免水分离的双钩套扎针辅助单孔腹腔镜内环腹膜外结扎术.中国微创外科杂志,2019,19(2):157-160.

备注/Memo

备注/Memo:
*通讯作者，Email：duangq453@sina.com
更新日期/Last Update: 2021-12-09