[1]陈嘉 屠义梅 汤劲松 王绘楠 戚腾*.筋膜闭合器辅助单孔腹腔镜完全腹膜外疝囊结扎术381例[J].中国微创外科杂志,2023,01(1):30-34.
　Chen Jia,Tu Yimei,Tang Jinsong,et al.Minigrasping Forces Assisted Singleport Laparoscopic Inner Inguinal Hernia Totally Extraperitoneal Ligation[J].Chinese Journal of Minimally Invasive Surgery,2023,01(1):30-34.
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筋膜闭合器辅助单孔腹腔镜完全腹膜外疝囊结扎术381例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年1期
页码:
30-34
栏目:
临床研究
出版日期:
2023-01-25

文章信息/Info

Title:
Minigrasping Forces Assisted Singleport Laparoscopic Inner Inguinal Hernia Totally Extraperitoneal Ligation
作者:
陈嘉 屠义梅 汤劲松 王绘楠 戚腾*
(江苏省苏北人民医院疝外科，扬州225000)
Author(s):
Chen Jia;  Tu Yimei;  Tang Jinsong;  et al.
Department of Hernia Surgery, Northern Jiangsu People’s Hospital, Yangzhou 225000, China
关键词:
腹股沟疝; 单孔腹腔镜; 腹膜外结扎
Keywords:
Inguinal hernia; Singleport laparoscopy; Extraperitoneal ligation
文献标志码:
A
摘要:
目的探讨使用筋膜闭合器辅助单孔腹腔镜完全腹膜外疝囊结扎术的可行性和安全性。方法2020年9月~2021年12月我科对381例517侧小儿腹股沟斜疝采用筋膜闭合器辅助单孔腹腔镜完全腹膜外疝囊结扎术，单孔腹腔镜监视下，将筋膜闭合器挂线经腹股沟内环体表穿刺，一次穿刺腹壁保持进出线在同一路径，完全在腹膜外间隙内实现置线和带线出体外，采用或不采用水分离技术环绕疝缺损腹膜外双重结扎内环。结果手术均顺利完成，术中诊断单侧腹股沟斜疝245例，双侧腹股沟斜疝136例；104例术前诊断单侧腹股沟斜疝，术中发现对侧隐匿性疝，均予以同期处理。手术时间单侧(8.9±1.3)min，双侧(14.6±1.8)min，术中无输精管、精索血管损伤。358例术后随访6~18个月，平均12个月，无疝复发，无切口感染、医源性隐睾、睾丸萎缩、鞘膜积液及皮肤肉芽肿形成等并发症发生。结论采用筋膜闭合器辅助单孔腹腔镜完全腹膜外疝囊结扎术除保留原本双钩套扎针的优势外，内芯的微型抓钳设计可以避免双钩套扎针挂钩肠壁或腹膜的风险，是一种安全有效的简便方法。
Abstract:
ObjectiveTo investigate the feasibility and safety of minigrasping forceps assisted singleport laparoscopic inner inguinal hernia totally extraperitoneal ligation.MethodsFrom September 2020 to December 2021, clinical date of 381 children (517 sides) with indirect inguinal hernia in our hospital treated with minigrasping forces assisted singleport laparoscopic inner inguinal hernia totally extraperitoneal ligation were reviewed. Under the monitoring of singleport laparoscopy, the minigrasping forces were used to clamp the line and puncture through the surface of the inner ring, and the inlet and outlet line were kept in the same path. The suture was introduced and pulled from hernia ring surface for extraperitoneal doubleligation of hernia sac with or without the hydrodissection technique.ResultsAll the procedures were successfully performed, including 245 cases of unilateral inguinal hernia and 136 cases of bilateral inguinal hernia. Among those with a preoperative diagnosis of unilateral hernia, 104 cases of contralateral nonclosure of latent hernia were operated. The unilateral hernia operation time was (8.9±1.3) min, and bilateral hernia operation time was (14.6±1.8) min, respectively. Neither spermatic vessel nor vas deferens was damaged during the procedure. The average followup period was 12 months (range, 6-18 months). There was no recurrence, wound infection, iatrogenic cryptorchidism or testicular atrophy. No hydrocele of sheath or granuloma of skin occurred.ConclusionsMinigrasping forceps assisted singleport laparoscopic inner inguinal hernia totally extraperitoneal ligation is a simple, safe and effective method. It keeps the advantage of inner twohooked cannula and avoids puncture on the peritoneal and the risk of injuring intestinal duct or peritoneum during hooking suture.

参考文献/References:

[1]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.
[2]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.
[3]张军,葛军涛,魏延栋,等.单孔腹腔镜治疗小儿腹股沟嵌顿斜疝的探讨.中国微创外科杂志,2014,14(9):769-771.
[4]Xu Q, Liu SQ, Niu JH, et al. RETRACTED: A new technique for extraperitoneal repair of inguinal hernia. J Surg Res,2016,204(2):452-459.
[5]Tatekawa Y. Laparoscopic extracorporeal ligation of hernia defects using an epidural needle and preperitoneal hydrodissection. J Endourol,2012,26(5):474-477.
[6]Saha M. Laparoscopic extracorporeal ligation of the internal inguinal ring by a spinal needle: a simple method of hernia repair in children. Indian J Surg,2016,78(2):85-89.
[7]刘雪来,张创,张永婷,等.单孔腹腔镜完全腹膜外腹股沟疝环结扎术的临床应用.发育医学电子杂志,2018,6(2):77-81.
[8]孙衍模,卢鹏,林一鹏.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治疗小儿腹股沟斜疝.中华疝和腹壁外科杂志(电子版),2020,14(3):251-253.
[9]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.
[10]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.
[11]唐睿,段光琦,刘洁,等.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.中国微创外科杂志,2021,21(9):782-786.
[12]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.

备注/Memo

备注/Memo:
*通讯作者，Email:qtljx8264153@163.com
更新日期/Last Update: 2023-04-23