小儿嵌顿性腹股沟疝的腹腔镜治疗方法
Laparoscopic approach to incarcerated inguinal hernia in children.
作者信息
Kaya Mete, Hückstedt Thomas, Schier Felix
机构信息
Department of Pediatric Surgery, University Medical Center Mainz, 55101 Mainz, Germany.
出版信息
J Pediatr Surg. 2006 Mar;41(3):567-9. doi: 10.1016/j.jpedsurg.2005.11.066.
PURPOSE
The purpose of this study was to describe the laparoscopic approach to incarcerated inguinal hernia in children.
METHODS
After unsuccessful manual reduction, 29 patients (aged 3 weeks to 7 years; median, 10 weeks; 44 boys, 15 girls) with incarcerated inguinal hernia underwent immediate laparoscopy. The hernial content was reduced in a combined technique of external manual pressure and internal pulling by forceps. The bowel was inspected, and the hernia was repaired.
RESULTS
In all patients, the procedure was successful. No conversion to the open approach was required. Immediate laparoscopic herniorrhaphy in the same session was added. No complications occurred.
CONCLUSIONS
Laparoscopy allowed for simultaneous reduction under direct visual control, inspection of the incarcerated organ, and definitive repair of the hernia. Technically, it appears easier than the conventional approach because of the internal inguinal ring being widened by intraabdominal carbon dioxide insufflation. The hospital stay is shorter.
目的
本研究旨在描述儿童嵌顿性腹股沟疝的腹腔镜手术方法。
方法
29例（年龄3周至7岁；中位年龄10周；男44例，女15例）嵌顿性腹股沟疝患儿手法复位失败后立即行腹腔镜手术。采用外部手动加压和内部镊子牵拉相结合的技术还纳疝内容物。检查肠管并修补疝。
结果
所有患者手术均成功。无需中转开腹手术。同期行即时腹腔镜疝修补术。未发生并发症。
结论
腹腔镜手术可在直视下同时进行还纳、检查嵌顿器官并对疝进行确定性修补。从技术角度看，由于腹腔内二氧化碳气腹使腹股沟内环增宽，似乎比传统方法更容易。住院时间更短。
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