腹股沟型, 隐睾, 经鞘突口腹腔镜抵入法, 单孔腹腔镜监视下经阴囊入路睾丸引降固定术," /> 腹股沟型, 隐睾, 经鞘突口腹腔镜抵入法, 单孔腹腔镜监视下经阴囊入路睾丸引降固定术,"/> Palpable inguinal canalicular, Cryptorchidism, Laparoscope approaching scrotum via inner ring orifice, Laparoscopic assisted transcrotal orchidopexy,"/> <span style="line-height:2;font-size:14px;">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</span>
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发育医学电子杂志  2019, Vol. 7 Issue (4): 259-263    DOI: 10.3969/j.issn.2095-5340.2019.04.005
  结构畸形   论著 |
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
刘雪来 李龙 李索林 王文博 杨晓锋 葛晓丽
1. 首都儿科研究所附属儿童医院 外科,北京 100020;2. 河北医科大学第二医院 小儿外科,河北 石家庄 050000
Application of laparoscope approaching scrotum via inner ring orifice in transcrotal orchidopexy for treatment of palpable inguinal canalicular cryptorchidism
LIU Xue-lai, LI Long, LI Suo-lin, et al
1. Department of Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China; 2. Department of Pediatric Surgery, the Second Hospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China
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摘要 【摘要】 目的 介绍单孔腹腔镜监视下经阴囊入路睾丸引降固定术(laparoscopic assisted transcrotal orchidopexy, LATO)治疗腹股沟型隐睾中采用经鞘突口腹腔镜抵入法(laparoscope approaching scrotum via inner ring orifice, LASIRO)在体外快速准确找到鞘膜腔的方法。 方法 选择2018年1月至2019年4月行LATO治疗的35例37侧腹股沟型隐睾患儿为研究对象。采用LASIRO在体外快速准确找到鞘膜腔:经阴囊切口中心切开肉膜之后,重建气腹,将光源调暗的镜头经未闭鞘突口伸入患侧鞘突腔内,向阴囊切口抵进到阴囊内,经切口抵出。采用电刀打开鞘膜腔,牵出睾丸。之后采用桥法横断鞘状突,分离和松解精索,保护输精管,实施睾丸引降固定。术后随访手术效果、隐睾位置和并发症。 结果 37侧隐睾均在体外快速准确找到鞘膜腔,在腹腔镜监视下成功固定于阴囊。手术时间25~55 min,围术期未发现并发症。患儿均于术后第2 d出院。术后随访24例,随访时间1~16个月,睾丸均位于阴囊内,无回缩或萎缩,未见切口感染、腹股沟疝或鞘膜积液发生。 结论 采用LASIRO可在体外快速准确找到位置偏高的鞘膜腔,有助于暴露睾丸和实施引降固定,方法安全、准确、有效,操作简便灵活。保持了LATO的隐瘢痕特点,缩短了手术时间,符合微创精准和快速康复的治疗理念。
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关键词:  腹股沟型')" href="#">腹股沟型  隐睾  经鞘突口腹腔镜抵入法  单孔腹腔镜监视下经阴囊入路睾丸引降固定术    
Abstract: 【Abstract】 Objective To introduce a novel laparoscope approaching scrotum via inner ring orifice (LASIRO) technique in laparoscopic assisted transcrotal orchidopexy (LATO) for treatment of palpable inguinal canalicular cryptorchidism, in order to find extracorporally vaginal cavity quickly and precisely. Methods From January 2018 to April 2019, 35 children(37 sides) with palpable inguinal canalicular cryptorchidism who underwent LATO were selected. Before descending testis, LASIRO was used to find and expose tunica vaginalis testis. We reconstructed pneumoperitoneu after opening thecae through scrotal incision. The laparoscopic light was turned down and laparoscope passed patent processus vaginalis (PPV) into affected cavity of tunica vaginalis, and approach into scrotum though scrotal incision and then jack the wall of tunica vaginalis testis out through scrotal incision, followed by opening of tunica vaginalis testis using electronic knife and dragging out of testis in it. Afterwards, transcrotal dissection for orchidopexy was conducted and inner ring orifice was closed by single port laparoscopic percutaneous extracorporeal closure. The clinical outcomes, cryptorchidism position, and complications were followed up. Results A total of 37 sides for palpable inguinal canalicular cryptorchidism were promptly found and exposed tunica vaginalis testis and delivered into the scrotum successfully. The operative time was 25-55 min. There were no intra-operative complications. All of the children were discharged from hospital in two days after operation. Twenty-four children were followed up for 1-16 months without iatrogenic cryptorchidism or testicular atrophy, wound infection, hernia or hydrocele. Conclusions LASIRO is a prompt and precise technique to find and expose tunica vaginalis testis elevating. It is helpful to expose orchis and carry out transcrotal orchidopexy, which is safe, accuracy and cosmetics in practice. The scars are invisible and the peration time is short, in keeping with the concept of the minimally invasive precison and rapid rehahilitation.
Key words:  Palpable inguinal canalicular')" href="#">Palpable inguinal canalicular    Cryptorchidism    Laparoscope approaching scrotum via inner ring orifice    Laparoscopic assisted transcrotal orchidopexy
收稿日期:  2019-05-18                出版日期:  2019-10-30      发布日期:  2019-11-13      期的出版日期:  2019-10-30
基金资助: 公益性行业科研专项(201402007);北京市医院管理局儿科学科协同发展中心儿科专项重点项目子课题(XTZD20180302)
通讯作者:  李龙https://baike.baidu.com/item/%E6%9D%8E%E9%BE%99/5301086?fr=aladdin    E-mail:  lilong23@126.com
引用本文:    
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.
LIU Xue-lai, LI Long, LI Suo-lin, et al. Application of laparoscope approaching scrotum via inner ring orifice in transcrotal orchidopexy for treatment of palpable inguinal canalicular cryptorchidism. Journal of Developmental Medicine(Electronic Version), 2019, 7(4): 259-263.
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