Franc-Guimond Julie, Kryger John, González Ricardo
Division of Pediatric Urology, Thomas Jefferson University, Alfred I. Dupont Hospital for Children, 1600 Rockland Road, PO Box 269, Wilmington, DE 19899, USA.
J Urol. 2003 Sep;170(3):936-8. doi: 10.1097/01.ju.0000081639.66752.e4.
We describe a variation of the Hasson technique for laparoscopic access.
All laparoscopic procedures performed in children and completed between September 1999 and May 2002 at 2 institutions were reviewed retrospectively. All access to the peritoneal cavity was accomplished in the same manner using the following approach-a small semicircumferential incision was made in the inferior part of the umbilicus, and the umbilical skin was dissected to expose the area of the umbilical scar where the peritoneum and the skin meet. At this point the peritoneum was opened under direct vision without an incision. A blunt trocar was then easily introduced into the peritoneal cavity without forceful manipulation. The rest of the procedure was accomplished as usual.
Seventy-seven laparoscopic procedures were completed in 77 patients (mean age 4.8 years, range 1 month to 17.75 years). Patient weight ranged from 8 to 66 kg. The procedures included diagnostic laparoscopy for undescended testis (52), varicocelectomy (11), nephrectomy (6), nephroureterectomy (1) and others (7). All attempts were successful. Mean followup was 15.9 months.
The most important advantage of this technique is that it offers easy and safe access to the peritoneal cavity even in obese individuals. In addition, this access is rapidly accomplished and offers good cosmetic results.
我们描述一种改良的哈森技术用于腹腔镜手术入路。
回顾性分析1999年9月至2002年5月期间在两家机构为儿童实施并完成的所有腹腔镜手术。所有进入腹腔的操作均采用以下相同方法进行——在脐部下缘做一个小的半环形切口，分离脐部皮肤以暴露腹膜与皮肤相接处的脐瘢痕区域。此时，在直视下不做切口打开腹膜。然后将钝性套管针轻松插入腹腔，无需强行操作。其余操作按常规完成。
77例患者完成了77例腹腔镜手术（平均年龄4.8岁，范围1个月至17.75岁）。患者体重8至66千克。手术包括隐睾诊断性腹腔镜检查（52例）、精索静脉曲张切除术（11例）、肾切除术（6例）、肾输尿管切除术（1例）及其他手术（7例）。所有尝试均成功。平均随访15.9个月。
该技术最重要的优点是即使对于肥胖个体也能提供简便、安全的腹腔入路。此外，这种入路操作迅速且美容效果良好。
