Tainaka Takahisa, Uchida Hiroo, Ono Yasuyuki, Tanano Akihide, Shirota Chiyoe, Yokota Kazuki, Murase Naruhiko, Makita Satoshi, Shirotsuki Ryo
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2015 Aug;77(3):531-5.
Femoral hernias are relatively rare in children, and more than half of pediatric femoral hernias are misdiagnosed. A 3-year-old boy was treated for an indirect inguinal hernia at the age of 2, but he exhibited an inguinal bulge one month after the operation. He underwent laparoscopy, and a right femoral hernia was detected. The femoral hernia was laparoscopically repaired via two small incisions: a 1.0-cm umbilical incision for a 3-mm 30° laparoscope and 3-mm grasping forceps and a 5-mm right lateral incision for 3-mm grasping forceps. After the hernia sac had been reflected into the abdominal cavity and resected, the iliopubic tract was sutured to Cooper's ligament using a laparoscopic percutaneous extracorporeal closure (LPEC) needle and 2-0 non-absorbable sutures. Laparoscopy enables the accurate diagnosis of rare and often missed pediatric femoral hernias. Our laparoscopic technique for treating femoral hernias is easy and effective. Although these early results are encouraging, more cases involving longer follow-up periods should be accumulated to confirm the efficacy of our technique.
股疝在儿童中相对少见，超过半数的小儿股疝被误诊。一名3岁男孩在2岁时因腹股沟斜疝接受治疗，但术后1个月出现腹股沟区肿物。他接受了腹腔镜检查，发现右侧股疝。通过两个小切口对股疝进行腹腔镜修补：一个1.0 cm的脐部切口用于置入3 mm的30°腹腔镜和3 mm抓钳，一个5 mm的右侧腹壁切口用于置入3 mm抓钳。将疝囊还纳至腹腔并切除后，使用腹腔镜经皮体外缝合（LPEC）针和2-0不可吸收缝线将髂耻束缝合至Cooper韧带。腹腔镜检查能够准确诊断罕见且常被漏诊的小儿股疝。我们的腹腔镜治疗股疝技术简便有效。尽管这些早期结果令人鼓舞，但仍需积累更多长期随访的病例以证实我们技术的疗效。
