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经皮内环缝合法在儿童腹腔镜腹股沟疝修补术中的应用

Laparoscopic inguinal hernia repair in children via PIRS (percutaneous internal ring suturing).

作者信息

Frýbová B, Trčka J, Dotlačil V, Poš L, Patkowski D, Rygl M

出版信息

Rozhl Chir. 2020 Spring;99(6):277-281. doi: 10.33699/PIS.2020.99.6.277-281.

Abstract

INTRODUCTION

The miniinvasive approach is a trend in pediatric surgery nowadays. The new surgical technique called percutaneous internal ring suturing (PIRS) is a promising method bringing all the benefits of miniinvasive surgery.

METHODS

Prospective study of patients operated on using the PIRS technique from 01 January 2018 to 01 January 2020 at the Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University, University Hospital Motol.

RESULTS

73 patients (25 boys and 48 girls) were operated on using PIRS. The median age was 68 months. 90 % of operations were performed by the same team of surgeons. During the procedure there were found 53 right-sided and 38 left-sided inguinal hernias. In 18 cases the hernia was bilateral, but only in 13 cases was this diagnosis made before the operation. A non-absorbable stitch was used in 57 cases to close the internal ring of the inguinal canal, and a non-absorbable monofilament in 16. The median operating time was 34 minutes. There were 3 recurrences (3.3 %) in our study.  Conclusion: In our initial study, the PIRS technique proved to be a safe alternative method to the open inguinal hernia surgery. This method provides the benefit of allowing to revise the contralateral inguinal canal as a prevention of a metachronous inguinal hernia. The cosmetic results were excellent.

摘要

引言

微创方法是当今小儿外科的一种趋势。一种名为经皮内环缝合术(PIRS)的新手术技术是一种有前景的方法,它带来了微创手术的所有益处。

方法

对2018年1月1日至2020年1月1日在查理大学医学院第二附属医院Motol大学医院小儿外科采用PIRS技术进行手术的患者进行前瞻性研究。

结果

73例患者(25名男孩和48名女孩)接受了PIRS手术。中位年龄为68个月。90%的手术由同一组外科医生进行。术中发现53例右侧腹股沟疝和38例左侧腹股沟疝。18例为双侧疝,但术前仅13例做出此诊断。57例使用不可吸收缝线关闭腹股沟管内环,16例使用不可吸收单丝缝线。中位手术时间为34分钟。本研究中有3例复发(3.3%)。结论:在我们的初步研究中,PIRS技术被证明是开放性腹股沟疝手术的一种安全替代方法。该方法的优点是可以检查对侧腹股沟管,以预防异时性腹股沟疝。美容效果极佳。

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