[1]刘雪来**孙婧瑄许坚吉李响陈钰嫱.两孔法腹腔镜内环缝扎治疗年龄≤3个月腹股沟斜疝的手术技巧[J].中国微创外科杂志,2025,01(9):566-569.
　Liu Xuelai,Sun Jingxuan,Xu Jianji,et al.Techniques on Twoport Laparoscopic Internal Ring Suturing for Inguinal Indirect Hernia in Children ≤ 3 Months Old[J].Chinese Journal of Minimally Invasive Surgery,2025,01(9):566-569.
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两孔法腹腔镜内环缝扎治疗年龄≤3个月腹股沟斜疝的手术技巧()

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

卷:
01
期数:
2025年9期
页码:
566-569
栏目:
技术改良
出版日期:
2025-09-25

文章信息/Info

Title:
Techniques on Twoport Laparoscopic Internal Ring Suturing for Inguinal Indirect Hernia in Children ≤ 3 Months Old
作者:
刘雪来**孙婧瑄许坚吉李响陈钰嫱
(首都医科大学附属首都儿童医学中心普通外科，首都儿科研究所，北京100020)
Author(s):
Liu Xuelai;  Sun Jingxuan;  Xu Jianji;  et al.
Department of General Surgery, Capital Center for Children’s Health, Capital Medical Univerisity, Capital Institute of Pediatrics, Beijing 100020, China
关键词:
斜疝; 内环缝扎; 腹腔镜; 儿童
Keywords:
Indirect hernia; Internal ring suturing; Laparoscopy; Children
文献标志码:
B
摘要:
目的探讨3 mm腹腔镜针持联合30带针尼龙线用于体外丝线牵拉辅助两孔法腹腔镜内环缝扎治疗年龄≤3个月腹股沟斜疝的安全性、可行性。方法2020年1月~2024年9月，49例年龄≤3个月的斜疝患儿接受两孔法腹腔镜内环缝扎。术中见均存在内环口周围腹膜冗厚，在经脐单孔腹腔镜监视下，使用30带针尼龙线，3 mm腹腔镜针持持针经内环口外下缘入腹膜，于腹膜后间隙走行，体外丝线牵拉冗厚腹膜，使缝针于腹膜后间隙内顺利跨越精索血管表面、Doom三角区和输精管(男孩)或子宫圆韧带(女孩)表面，环形缝扎和闭合内环口。结果手术时间35例单侧(13.5±2.5)min，14例双侧(24.5±3.5)min。无术中并发症，均在术后6 h内出院。失访3例，46例随访6~26个月(平均9.5月)，其中19例随访>12个月。无复发疝、切口感染、鞘膜积液、医源性隐睾或睾丸萎缩等并发症。结论对于年龄≤3个月的斜疝患儿，应用3 mm腹腔镜针持联合30带针尼龙线进行体外丝线牵拉、内环缝扎，操作灵活、便利，使两孔法腹腔镜内环缝扎安全、可行。
Abstract:
ObjectiveTo explore the safety and feasibility of 3mm laparoscopic needle holder combined with 30 needlethread nylon in external silk thread tractionassisted twoport laparoscopic internal ring suturing for the treatment of inguinal indirect hernia in children ≤ 3 months old.MethodsFrom January 2020 to September 2024, 49 children ≤ 3 months old with indirect hernia underwent external silk thread tractionassisted twoport laparoscopic internal ring suturing. All the patients were found to complicated with redundant peritoneum around internal ring. Under transumbilical singleport laparoscopic monitoring, the 3mm laparoscopic needle holder holing the 30 needlethread nylon was inserted through the inferior edge of the internal ring, entering the peritoneum and traveling through the retroperitoneal space. The external nylon thread was advanced to drag the redundant peritoneum, allowing the suture needle cross the surface of the spermatic cord vessels, the Doom’s triangle, and the vas deferens (boys) or the uterine round ligament (girls) in the retroperitoneal space, followed by circular suturing and closure of the internal ring.ResultsThe surgery time was (13.5±2.5) min for the 35 cases of unilateral hernia and (24.5±3.5) min for the 14 cases of bilateral hernia. No intraoperative complications occurred, and all the patients were discharged within 6 h postoperation. Except for 3 children of lost to followup, 46 children were followed up for 6-26 months (mean, 9.5 months), with 19 cases followed for > 12 months. No complications such as recurrence, wound infection, hydrocele, iatrogenic undescended testicle, or testicular atrophy were observed during the followups.ConclusionFor children ≤ 3 months old with indirect hernia, the use of 3mm laparoscopic needle holder combined with 30 needlethread nylon in external silk thread tractionassisted twoport laparoscopic internal ring suturing enhances the flexibility and convenience of the procedure, being safety and feasibility.

参考文献/References:

[1]中华医学会小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)(上篇).中华疝和腹壁外科杂志(电子版),2018,12(1):1-5.
[2]中华医学会小儿外科学分会内镜外科学组.小儿腹股沟疝腹腔镜手术操作指南(2017版)(下篇).中华疝和腹壁外科杂志(电子版),2018,12(2):81-85.
[3]刘雪来,叶茂,丁柏匀,等.体外丝线牵拉辅助两孔腹腔镜内环缝合在治疗内环口皱褶冗厚斜疝中的应用.中国微创外科杂志,2024,24(1):7-12.
[4]刘雪来,李龙,李索林,等.输精管-髂外血管间隙在免水分离SPLPEC手术治疗内环皱褶明显儿童斜疝中的应用.临床小儿外科杂志,2020,19(5):426-431.
[5]叶茂,陈震,范世莹,等.腹腔镜手术治疗儿童嵌顿斜疝170例中长期疗效.中国微创外科杂志,2024,24(11):726-730.
[6]Shou T,Zhong H,Wang F.Transumbilical twoport laparoscopic suturing of the inguinal hernia defect with percutaneous assistance:a safe and efficient scarless surgery for pediatric inguinal hernia repair.Hernia,2018,22(4):681-684.
[7]Grech G,Shoukry M.Laparoscopic inguinal hernia repair in children:article review and the preliminary Maltese experience.J Pediatr Surg,2022,57(6):1162-1169.
[8]DiSclafani M,Richards D,Schneider A,et al.Intraluminal stent optimization for the baerveldt glaucoma implant: an experimental study.J Glaucoma,2021,30(7):e334-e337.
[9]Tzimas V,Kotsias C,Galanis C,et al.Comparative study of surgical wound closure with nylon interrupted sutures and running subcuticular vicryl rapide suture after open release of the carpal tunnel.Scars Burn Heal,2022,8:20595131221128951.

备注/Memo

备注/Memo:
基金项目：北京市卫生健康委员会2024-2025年度“一带一路”国际卫生健康合作项目和世界卫生组织合作中心项目；北京市自然科学基金(7222015)；首都儿科研究所所级课题(LCYJ-2023-07)**通讯作者，Email：liuxuelai_steven@163.com
更新日期/Last Update: 2025-10-17