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腹腔镜下修复莫尔加尼疝:一种创新方法。

Laparoscopic repair of Morgagni's hernia: An innovative approach.

作者信息

Shah Rasik S, Sharma Pradeep Chandra, Bhandarkar Deepraj S

机构信息

Department of Paediatric Surgery, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, Maharashtra, India.

Department of Minimal Access Surgery, P. D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai, Maharashtra, India.

出版信息

J Indian Assoc Pediatr Surg. 2015 Apr-Jun;20(2):68-71. doi: 10.4103/0971-9261.151547.

Abstract

AIM

To review our experience of laparoscopic repair of Morgagni's hernia (MH) using transfascial sutures.

MATERIALS AND METHODS

This is a retrospective review of patients presenting to the first author with the diagnosis of MH over a 15-year period. The variables analyzed included demographic data, clinical presentation, and operative details.

RESULTS

In all there were five male with a median age of 2 years. They were asymptomatic and MH was detected incidentally by observing an air-filled density in the right cardiophrenic angle on plain X-ray of the chest. Computed tomography (CT) confirmed the diagnosis in all patients. All patients underwent laparoscopic repair of MH using transfascial sutures. The average operative time was 75 min. Oral feeding was started 6 h after surgery and patients were discharged on either 3(rd) or 4(th) postoperative day. Postoperative follow-up X-ray confirmed the intact repair.

CONCLUSIONS

Laparoscopic repair of MH using transfascial sutures is an easy and effective solution. Multiple horizontal mattress sutures taking full thickness of abdominal wall muscles with the edge of the diaphragm leads to a strong repair. As sutures are tied extracorporeally, the technique is easily reproducible.

摘要

目的

回顾我们使用经筋膜缝合进行腹腔镜下莫尔加尼疝(MH)修补术的经验。

材料与方法

这是一项对在15年期间向第一作者就诊并诊断为MH的患者进行的回顾性研究。分析的变量包括人口统计学数据、临床表现和手术细节。

结果

共有5名男性患者,中位年龄为2岁。他们无症状,通过胸部X线平片观察到右心膈角处有充气密度影而偶然发现MH。计算机断层扫描(CT)在所有患者中均证实了诊断。所有患者均采用经筋膜缝合进行腹腔镜下MH修补术。平均手术时间为75分钟。术后6小时开始经口喂养,患者在术后第3天或第4天出院。术后随访X线证实修补完整。

结论

使用经筋膜缝合进行腹腔镜下MH修补术是一种简单有效的解决方案。多根水平褥式缝合线穿过腹壁肌肉全层并与膈肌边缘缝合,可实现牢固的修补。由于缝合线在体外打结,该技术易于重复操作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ae/4360457/8672a6e16be8/JIAPS-20-68-g001.jpg

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