Bawazir Osama Abdullah, Bawazir Razan
Department of Surgery, Faculty of Medicine, Umm Al-Qura University, Makkah; Department of Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, KSA.
Medical Student, Medical College, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, KSA.
Afr J Paediatr Surg. 2021 Jan-Mar;18(1):9-13. doi: 10.4103/ajps.AJPS_109_20.
Because of the restricted space of the peritoneal cavity and the easy mobility of abdominal and pelvic organs in infants and neonates, the boundary of minimally invasive surgery was extended to complete the operation outside the abdomen. The objective of this study was to report our experience with transumbilical laparoscopic-assisted surgery (TULS) in different abdominal pathologies in infants and neonates.
A retrospective study was conducted on 59 patients who underwent TULS from 2014 to 2020. The study outcomes were the conversion to open approach, length of hospital stay and post-operative complications.
The most common indications were explorations for intra-abdominal testes (n = 15) and inguinal herniorrhaphy (n = 13). Patients who had surgery for pyloric stenosis were younger (1.03 ± 0.25 months). The average operative time was 45.9 ± 18.39 min. The longest operative time was reported with surgery for liver cysts (94.5 ± 10.6 min). Oral intake was started after 48-56 h in patients who had excision of duplication cysts. The average post-operative hospital stay was 2.6 ± 1.52 days. No major complications were reported. Wound infection occurred in one patient with a duplication cyst. Three patients were converted to open repair (5.1%) and no late complications were reported during the mean follow-up time of 11.2 ± 5.1 months.
The transumbilical approach is a safe alternative method to laparotomy in several abdominal pathologies in infants and neonates. It has a short operative time and hospital stay. The technique is associated with few complications and conversion rates.
由于婴儿和新生儿腹腔空间有限且腹部和盆腔器官活动度大，微创手术的边界得以扩展至在腹腔外完成手术。本研究的目的是报告我们在婴儿和新生儿不同腹部疾病中进行经脐腹腔镜辅助手术（TULS）的经验。
对2014年至2020年接受TULS的59例患者进行回顾性研究。研究结果包括转为开放手术、住院时间和术后并发症。
最常见的适应证是腹腔内睾丸探查（n = 15）和腹股沟疝修补术（n = 13）。接受幽门狭窄手术的患者年龄较小（1.03 ± 0.25个月）。平均手术时间为45.9 ± 18.39分钟。肝囊肿手术的手术时间最长（94.5 ± 10.6分钟）。重复囊肿切除患者在术后48 - 56小时开始经口进食。平均术后住院时间为2.6 ± 1.52天。未报告重大并发症。1例重复囊肿患者发生伤口感染。3例患者转为开放修复（5.1%），在平均11.2 ± 5.1个月的随访期间未报告晚期并发症。
经脐入路是婴儿和新生儿几种腹部疾病中开腹手术的一种安全替代方法。它手术时间短，住院时间短。该技术并发症少，转换率低。
