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[腹腔镜辅助经皮治疗婴幼儿腹股沟疝]

[Laparoscopic assisted percutaneous treatment of inguinal hernia in infants].

作者信息

Molina Vázquez M E, Sánchez Abuín A, Aguilar Cuesta R

机构信息

Servicio de Cirugía Pediátrica, Hospital Clínico Universitario de Valladolid.

出版信息

Cir Pediatr. 2012 Jan;25(1):4-8.

Abstract

INTRODUCTION

Thanks to the generalization of minimally invasive surgery in pediatric patients some classic techniques are being replaced. Inguinal hernia repair may be an example.

MATERIAL AND METHODS

We present the technique and our first results in 10 patients treated by percutaneous laparoscopic assisted herniotomy. For this purpose we used an umbilical port, for a 5 mm camera and an optional 2 mm grasper. By laparoscopic guidance we make two inguinal punctures with a 20G needle that introduces a non absorbable suture that crosses the whole inguinal defect and allows it closure by extracorporeal knot tying.

RESULTS

The ages ranged between 1 month and 8 years with a median age of 10 months. 50% of the patients were boys. 50% of the patients had previous diagnosis of inguinal bilateral hernia. 30% of patients presented a postoperatory diagnosis different from the previous one. The average time of intervention was 32 minutes in bilateral hernias, and 19 in the unilateral ones. Follow-up time was 6 months without complications. The aesthetic result was ideal.

CONCLUSION

Percutaneous laparoscopic assisted herniotomy is an effective, simple and feasible option for inguinal hernia in chidren without a high rate of complications.

摘要

引言

由于小儿患者微创手术的普及,一些经典技术正在被取代。腹股沟疝修补术可能就是一个例子。

材料与方法

我们介绍了经皮腹腔镜辅助疝囊高位结扎术的技术及我们对10例患者的初步治疗结果。为此,我们使用了一个脐部端口,用于放置5毫米的摄像头和一个可选的2毫米抓钳。在腹腔镜引导下,我们用20G针头进行两次腹股沟穿刺,引入一根不可吸收缝线,该缝线穿过整个腹股沟缺损处,并通过体外打结实现闭合。

结果

患者年龄在1个月至8岁之间,中位年龄为10个月。50%的患者为男孩。50%的患者之前被诊断为双侧腹股沟疝。30%的患者术后诊断与术前不同。双侧疝的平均干预时间为32分钟,单侧疝为19分钟。随访时间为6个月,无并发症。美学效果理想。

结论

经皮腹腔镜辅助疝囊高位结扎术是治疗小儿腹股沟疝的一种有效、简单且可行的方法,并发症发生率不高。

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