持针式单孔法治疗小儿疝的解剖学基础与手术技巧
彭永辉, 黎灿强, 林伟斌, 谢志华, 龚独辉, 莫宇轩, 聂向阳
中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (1) : 100-103.
持针式单孔法治疗小儿疝的解剖学基础与手术技巧
The surgical skills based on anatomic experience for treating the pediatric hernia by the single-port technique
目的 总结持针式单孔法治疗小儿腹股沟疝的应用解剖及手术技巧。 方法 回顾性分析我院2009年3月至2013年4月,采用持针式单孔法腹腔镜治疗小儿腹股沟疝1735例。右侧892例、左侧595例、双侧248例。均为男孩,年龄23.5~36.8月,平均26.7月。 结果 1735例患儿均在腹腔镜下顺利完成疝囊高位结扎术。除早期出现1例髂血管血肿外,其余无与解剖因素有关的损伤或并发症。 结论 正确认识手术区域的解剖是手术成功与否的基础及关键,而熟练的手术操作是减少手术并发症,降低手术复发率及提高手术安全性的有力保障。
Objective To summarize our anatomic experience and surgical skills to treating the pediatric hernia by the single-port technique. Method A total of 1735 boys with the inguinal hernia who underwent single-port laparoscopic hernia repair were retrospectively included. The mean age was 26.7 months (range from 23.5 to 36.8 month). A right-sided hernia was observed in 892 boys, a left-sided hernia in 595 boys and a bilateral hernia in 248 boys. Result All procedures were performed successfully without any serious complications resulting from anatomical factors, except for one case of iliac vessel hematoma. Conclusion Better anatomic understanding of surgical region is crucial for successful laparoscopic hernia repair operation, and practiced technique is the key for improving the surgical safety and preventing complications and recurrence.
Pediatric hernia / Single-port technique with needle-holder / Anatomy / Operation skill
[1] 宋晋,刘忠理,赵路红,等. 经脐单孔法腹腔镜下治疗小儿腹股沟斜疝临床观察[J]. 长治医学院学报, 2015, 29(3):193-194.
[2] 刘建,张勇,祝东强,刘恒,等,经脐单孔腔镜下应用自制双孔缝合针治疗小儿腹股沟斜疝[J]. 四川医学,2011, 32(4): 543-545.
[3] 李萌,李索林,于增文,等.单孔腹腔镜改良疝钩针经皮腹膜外结扎术治疗小儿腹股沟疝[J].中华小儿科杂志, 2012, 33(12): 916-919.
[4] 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[J].中华小儿外科科杂志, 2012, 33(10): 751-753.
[5] Read RC.Recent advances in the repair of groin herniation[J].Curr Probl Surg,2003,40(1):13-79.
[6] 刘素君, 王帆, 朱熠林, 等. 钳式针辅助单孔腹腔镜治疗儿童腹股沟疝微创分析[J]. 中华疝和腹壁外科杂志(电子版), 2014, 8(1):17-20.
[7] Peng Y,Li C, Lin W, et al. Application of a laparoscopic,single-port,double-needle technique for pediatric hydroceles with multiple peritoneal folds:A trial from a single-center 5-year experience[J]. Urology,2015,85(6):1466-1470.
[8] 李索林,刘琳,杨晓锋,等,腹腔镜技术诊治小儿腹股沟斜疝的现状与评价[J]. 中华小儿外科科杂志, 2014, 35(6): 406-409.
[9] 段光琦, 张敏,管肖浩. 单孔腹腔镜治疗小儿腹股沟斜疝55例分析[J]. 中华疝和腹壁外科杂志(电子版), 2013, 7(13):255-257.
[10] 吴东波,黄顺荣, 吴鸿根. 小儿腹腔镜腹股沟疝手术的手术方式和并发症[J]. 中国内镜杂志, 2010,16 (11):1160-1163.
[11]Li S, Liu L, Li M. Single-port laparoscopic percutaneous extraperitoneal closure using an innovative apparatus for pediatric inguinal hernia[J]. J Laparoendosc Adv Surg Tech A, 2014, 24(3):188-193.
[12]Spaw AT,Ennis BW,Spaw LP. Laparoscopic hernia repair:the anatomic basis[J].J Laparoendosc Surg, 1991, l(5):269-277.
广东省医学科研基金资助项目(A2013577)
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