de Lima George Rafael Martins, da Silveira Rômulo Augusto, de Cerqueira João Batista Gadelha, de Abreu Augusto César Gadelha, de Abreu Filho Augusto César Gadelha, Rocha Marcos Flávio Holanda, Regadas Rommel Prata, Gonzaga-Silva Lúcio Flávio
Federal University of Ceará, Fortaleza, Brazil.
J Pediatr Surg. 2009 Oct;44(10):2054-6. doi: 10.1016/j.jpedsurg.2009.06.030.
We report the first use of single-incision multiport access to perform 1-stage laparoscopic orchidopexy in children without section of the spermatic vessels.
Three boys with cryptorchidism were submitted to primary laparoscopic 1-stage orchidopexy by using 3 ports (a 10-mm [or 5-mm] port placed using open technique and 2 additional 5-mm [or 3-mm] ports) inserted through the same periumbilical skin incision with different entrances through the abdominal wall. After dissection of the testicular vessels and vas deferens, a 5-mm port was placed in a tunnel from the scrotum to pull the remnant of the gubernaculum down and fix the testicle in a dartos pouch.
The mean operative time was 83.3 minutes. The estimated blood loss was almost nil, and there were no intraoperative complications.
This approach was feasible and safe. However, as with any new technique, its use requires a larger number of cases and a longer follow-up to fully evaluate its benefits and limitations.
我们报告首次使用单切口多通道入路在不切断精索血管的情况下为儿童进行一期腹腔镜睾丸固定术。
对3例隐睾患儿采用经脐部同一皮肤切口插入3个通道（一个采用开放技术置入的10毫米[或5毫米]通道以及另外2个5毫米[或3毫米]通道）进行一期腹腔镜睾丸固定术，这些通道经腹壁有不同的进入点。在游离睾丸血管和输精管后，通过从阴囊置入的一个5毫米通道形成隧道，将睾丸引带残端下拉并将睾丸固定于肉膜囊内。
平均手术时间为83.3分钟。估计失血量几乎为零，且无术中并发症。
该方法可行且安全。然而，与任何新技术一样，其应用需要更多病例和更长时间的随访，以充分评估其益处和局限性。
