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儿童 Morgagni 疝的腹腔镜修补术。

Laparoscopic Repair of Morgagni Hernia in Children.

机构信息

Department of Pediatric Surgery, Uludag University Medical Faculty, Bursa, Turkey.

出版信息

J Laparoendosc Adv Surg Tech A. 2022 Jul;32(7):811-816. doi: 10.1089/lap.2021.0797. Epub 2022 Feb 11.

DOI:10.1089/lap.2021.0797
PMID:35443814
Abstract

This study aims to review laparoscopic repair techniques of Morgagni hernias at a tertiary referral center. This retrospective study includes pediatric patients who underwent laparoscopic repair of Morgagni hernia between March 2004 and March 2021. The patients' demographics, presenting symptoms, operative approach, and postoperative outcomes were recorded. Fourteen patients underwent laparoscopic repair of Morgagni hernia. The mean age at the time of operation was 24.7 months. Defect closing techniques were intracorporeal knot tying (: 2), extracorporeal knot tying, and subcutaneous knot placement (: 10), combination with intracorporeal continuous suturing and several extracorporeal intermittent sutures (: 2). Different approaches were used during removal of the needle from the insertion point in the extracorporeal knot tying: intracorporeally, using a laparoscopic needle holder (: 6), with an 18-gauge injector tip (: 1), and extracorporeally with suture passer forceps (: 3). In the intracorporeal knot tying technique, the mean operation time was 127 minutes (range 90-180 minutes). In the extracorporeal knot tying technique, the mean operation time was 75 minutes (range 30-180 minutes). The mean operation time in the technique that used suture passer forceps for removing the needle from the same point of insertion was 40 minutes. There was no intraoperative complication. In the laparoscopic repair of Morgagni hernia, full-thickness anterior abdominal wall repair with interrupted sutures that are tied extracorporeally in the subcutaneous tissue by separated minor skin incisions is the easy approach. Using suture passer forceps during removal of the needle facilitates this technique and shortens the operation time.

摘要

本研究旨在回顾一家三级转诊中心的 Morgagni 疝腹腔镜修补技术。这项回顾性研究纳入了 2004 年 3 月至 2021 年 3 月期间接受腹腔镜 Morgagni 疝修补术的儿科患者。记录了患者的人口统计学、临床表现、手术入路和术后结果。14 名患者接受了 Morgagni 疝的腹腔镜修补术。手术时的平均年龄为 24.7 个月。闭合缺陷的技术包括体内打结(2 例)、体外打结和皮下打结(10 例),结合体内连续缝合和几个体外间断缝合(2 例)。在体外打结时,从插入点取出针的不同方法:体内使用腹腔镜持针器(6 例)、18 号注射器尖端(1 例)和体外使用缝线穿线器(3 例)。在体内打结技术中,平均手术时间为 127 分钟(90-180 分钟)。在体外打结技术中,平均手术时间为 75 分钟(30-180 分钟)。使用缝线穿线器从同一插入点取出针的技术平均手术时间为 40 分钟。无术中并发症。在 Morgagni 疝的腹腔镜修补术中,采用间断全层腹壁修补,通过单独的小皮肤切口在皮下进行体外打结,是一种简单的方法。在取出针时使用缝线穿线器可简化该技术并缩短手术时间。

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