Lopez Pedro-Jose, Mushtaq Imran, Curry Joe I
Department of Paediatric Urology, Great Ormond Street Hospital, London, UK.
J Pediatr Urol. 2007 Feb;3(1):28-31. doi: 10.1016/j.jpurol.2006.03.001. Epub 2006 May 5.
Laparoscopy is now the established management for infants with inguinal hernia at our institution. Open inguinal herniotomy in children with bladder exstrophy can be a difficult operation and is associated with a high rate of recurrence (15%). Here, we report our initial experience with laparoscopic repair of inguinal hernia in three children with bladder exstrophy.
Three boys with repaired bladder exstrophy presented with inguinal hernia during follow up. The clinical presentation was bilateral in one and findings at surgery were bilateral open internal rings in two. Under general anaesthesia, pneumoperitoneum of 10 mmHg was raised with a Hasson port at the umbilicus. Two further instruments were inserted in the right and left flanks without ports. Two 4/0 Prolenetrade mark purse string sutures were placed to securely close the internal ring. The umbilicus was closed with an absorbable suture, and the skin incisions were closed with Indermil Gluetrade mark.
All infants made an uneventful recovery, being discharged within 24h. There were no complications. There has been no sign of recurrence during a mean follow up of 16 months.
Laparoscopic inguinal herniotomy is a technically straightforward and effective way to treat inguinal hernias in children with bladder exstrophy.
在我们机构，腹腔镜检查现已成为婴儿腹股沟疝的既定治疗方法。对于膀胱外翻患儿进行开放性腹股沟疝修补术可能是一项困难的手术，且复发率较高（15%）。在此，我们报告三例膀胱外翻患儿腹腔镜修补腹股沟疝的初步经验。
三名膀胱外翻修补术后的男孩在随访期间出现腹股沟疝。其中一名临床表现为双侧，两名手术发现双侧内环开放。在全身麻醉下，通过脐部的哈森端口建立10 mmHg的气腹。在左右侧腹无端口处插入另外两根器械。放置两根4/0普理灵缝线以牢固关闭内环。脐部用可吸收缝线缝合，皮肤切口用英德美胶水封闭。
所有婴儿恢复顺利，24小时内出院。无并发症发生。平均随访16个月期间无复发迹象。
腹腔镜腹股沟疝修补术是治疗膀胱外翻患儿腹股沟疝的一种技术上简单有效的方法。
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