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一种小儿腹腔镜腹股沟疝修补的新技术:单孔腹腔镜经皮腹膜外闭合术在光学钳辅助下进行

A novel technique for laparoscopic inguinal hernia repair in children: single-port laparoscopic percutaneous extraperitoneal closure assisted by an optical forceps.

作者信息

Yilmaz Engin, Afsarlar Cagatay Evrim, Senel Emrah, Cavusoglu Yusuf Hakan, Karaman Ibrahim, Karaman Ayse, Ozguner Ismet Faruk

机构信息

Department of Pediatric Surgery, Dr Sami Ulus Maternity and Children's Hospital, No: 44, Babur caddesi, Altındağ, 06080, Ankara, Turkey,

出版信息

Pediatr Surg Int. 2015 Jul;31(7):639-46. doi: 10.1007/s00383-015-3722-z. Epub 2015 May 20.

Abstract

AIM

The aim of this study was to describe and report the results of our new pediatric inguinal hernia repair technique, in which single-port laparoscopic percutaneous extraperitoneal closure (SPEC) technique was modified by using optical foreign-body forceps (OFF) of the rigid bronchoscope.

MATERIALS AND METHODS

Between January 2012 and January 2014, a total of 79 children who were operated using SPEC assisted with OFF (SPEC-OFF) were included in this study. Demographic and clinical features of the children were obtained and reviewed retrospectively.

RESULTS

Ninety-nine hernia repairs were performed on a total of 79 children (51 boys, 28 girls). All of the patients were operated by SPEC-OFF without the need of introducing extra forceps, with or without an additional trocar. The mean operating time was 17.6 ± 5.5 min. The mean follow-up period was 17.5 ± 7.1 months. There were six recurrences (two boys, four girls). No wound infection, hydroceles or testicular atrophy occurred in any patients during post-surgery follow-up. The technique left a very small scar with excellent cosmesis in the umbilicus and groin area.

CONCLUSIONS

SPEC-OFF is a simple, safe and effective technique for laparoscopic inguinal hernia repair, and for determining contralateral hernia. There is no need to use additional working forceps for the technique and the surgeon can perform the procedure without any assistance for laparoscope.

摘要

目的

本研究旨在描述并报告我们新的小儿腹股沟疝修补技术的结果,该技术是对单孔腹腔镜经皮腹膜外闭合术(SPEC)进行改良,采用硬质支气管镜的光学异物钳(OFF)。

材料与方法

2012年1月至2014年1月期间,本研究共纳入79例采用SPEC联合OFF(SPEC-OFF)进行手术的儿童。回顾性获取并分析了这些儿童的人口统计学和临床特征。

结果

共对79例儿童(51例男孩,28例女孩)进行了99次疝修补术。所有患者均通过SPEC-OFF进行手术,无需额外引入器械,无论是否使用额外的套管针。平均手术时间为17.6±5.5分钟。平均随访期为17.5±7.1个月。有6例复发(2例男孩,4例女孩)。术后随访期间,所有患者均未发生伤口感染、鞘膜积液或睾丸萎缩。该技术在脐部和腹股沟区域留下的疤痕非常小,美容效果极佳。

结论

SPEC-OFF是一种简单、安全且有效的腹腔镜腹股沟疝修补及对侧疝诊断技术。该技术无需使用额外的操作器械,外科医生可在无腹腔镜辅助的情况下完成手术。

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