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发育医学电子杂志  2018, Vol. 6 Issue (2): 77-81    
  结构畸形   论著 |
单孔腹腔镜完全腹膜外腹股沟疝环结扎术的临床应用
刘雪来 张创 张永婷 刘林 李索林
刘雪来 张创 张永婷 刘林 李索林 (河北医科大学第二医院 小儿外科,河北 石家庄 050000)
Clinical application for single-port laparoscopic percutaneous extraperitoneal closure in the treatment of inguinal hernia in children  
LIU Xue-lai, ZHANG Chuang, ZHANG Yong-ting, et al
LIU Xue-lai, ZHANG Chuang, ZHANG Yong-ting, LIU Lin,  LI Suo-lin (Department of Pediatric Surgery, The Second Hospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China )
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摘要 目的  对双钩套扎针辅助单孔腹腔镜完全腹膜外腹股沟疝环结扎术的临床应用进行总结,并探讨其安全性和有效性。方法 2017 年 7 月至 10 月,在河北医科大学第二医院小儿外科住院的患儿中,17 例腹股沟疝患儿接受了单孔腹腔镜下的完全腹膜外疝环结扎关闭术。经脐单孔腹腔镜监视下,将双钩套扎针钩挂结扎线经腹股沟内环体表穿刺,一次穿刺腹壁保持进出线在同一路径,完全在腹膜外间隙内实现置线和钩线带出体外。采用或不采用水分离技术环绕疝缺损腹膜外套扎内环。结果 17 例患儿中,11 例为单侧疝,6 例为双侧疝。单侧疝的平均手术时间为(10.5±2.3)分钟,双侧疝的平均手术时间为(16.6±1.5)分钟。无术中并发症发生。术后随访 2 ~ 5 个月,无一例出现伤口感染、医源性隐睾或睾丸萎缩等并发症,无复发疝、鞘膜积液和皮肤结肉芽肿形成。   结论 采用双钩套扎针辅助单孔腹腔镜完全腹膜外腹股沟疝环结扎术是一种安全有效的简便方法,避免了在腹膜上戳孔,双钩套扎针与丝线不再进入腹腔内置线和钩挂带出,实现了完全腹膜外结扎内环。
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关键词:  腹股沟疝  单孔腹腔镜  双钩套扎针  腹膜外结扎    
Abstract: Objective   To conclude the clinical application of inner two-hooked cannula assisted single-
port laparoscopic percutaneous extraperitoneal closure (SPLPEC) in the treatment of inguinal hernia in
children and to explore its feasibility and safety.   Methods From July to October 2017, 17 children with
inguinal hernia in Department of Pediatric Surgery of The Second Hospital of Hebei Medical University
underwent SPLPEC. Under the visualization of single port laparoscopic, an inner two-hooked cannula with
a suture was introduced into extraperitoneal space at the corresponding point of the internal inguinal ring,
that could be readily kept in an identical subcutaneous path. The internal ring ori?ce was absolutely lassoed
extraperitoneally by the suture without peritoneal punctures and withdrawn on the opposite side using the
cannula around the internal ring with or without the hydrodissection technique. Results Among the
17 cases of children, 11 cases were unilateral inguinal hernia and 6 cases were bilateral inguinal hernia.
The mean operating time of unilateral was (10.5±2.3) minutes and that of bilateral inguinal hernia
was (16.6±1.5) minutes. There were no intra-operative complications. Following up for 2-5 months
after operation, there were no wound infection, iatrogenic cryptorchidism or testicular atrophy and othercomplications. And no recurrence, hydroceles and suture granuloma formations were found.  Conclusion 
Inner two-hooked cannula assisted SPLPEC is a simple, safe and effective method. It avoids puncture on
the peritoneal. Inner two-hooked cannula and suture do not put and withdraw via intraperitoneal, achieving
extraperitoneal ligation of inner ring completely.
Key words:  Inguinal hernia         Single-port laparoscopy    Inner two-hooked cannula         Extraperitoneal ligation
收稿日期:  2018-01-09                出版日期:  2018-04-30      发布日期:  2018-05-22      期的出版日期:  2018-04-30
基金资助: 国家卫生与计划生育委员会重大公益性项目(201402007);河北省医学适用技术跟踪项目(G201720)
通讯作者:  李索林https://baike.baidu.com/item/%E6%9D%8E%E7%B4%A2%E6%9E%97/15777770    E-mail:  lisuolin@263.net
引用本文:    
刘雪来 张创 张永婷 刘林 李索林. 单孔腹腔镜完全腹膜外腹股沟疝环结扎术的临床应用[J]. 发育医学电子杂志, 2018, 6(2): 77-81.
LIU Xue-lai, ZHANG Chuang, ZHANG Yong-ting, et al. Clinical application for single-port laparoscopic percutaneous extraperitoneal closure in the treatment of inguinal hernia in children  . Journal of Developmental Medicine(Electronic Version), 2018, 6(2): 77-81.
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免水分离完全腹膜外改良钩针辅助单孔腹腔镜内环闭合术治疗儿童腹股沟斜疝
[J]. 发育医学电子杂志, 2020, 8(4): 333-337.
[2] 高鹏 张旭光 单颖君 等. 腹腔镜下单孔套扎和三孔缝扎治疗儿童精索鞘膜积液对肠道黏膜屏障功能的影响[J]. 发育医学电子杂志, 2020, 8(2): 145-150.
[3] 刘雪来 李龙 李索林 王文博 杨晓锋 葛晓丽. 经鞘突口腹腔镜抵入法在经阴囊入路睾丸引降固定术治疗腹股沟型隐睾中的应用[J]. 发育医学电子杂志, 2019, 7(4): 259-263.
[4] 刘雪来 李龙 李索林 曹学会 张永婷 刘林 李亮星. 腹膜闭合器改良钩针在小儿腹股沟疝手术中的应用[J]. 发育医学电子杂志, 2019, 7(3): 203-207.
[5] 刘雪来 张永婷 李索林. 免水分离改良钩针辅助单孔腹腔镜内环腹膜外闭合治疗儿童腹股沟斜疝[J]. 发育医学电子杂志, 2019, 7(2): 141-145.
[6] 陶天 周辉霞 王超 等. 小儿经脐单孔腹腔镜肾盂成形术经肠系膜途径与结肠旁途径的疗效比较[J]. 发育医学电子杂志, 2016, 4(3): 165-169.
[7] 胡啸天 彭澎 段支前. 经脐单孔腹腔镜下小儿重复肾半肾切除术的临床分析[J]. 发育医学电子杂志, 2016, 4(2): 99-103.
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