腹腔镜下自制缝针腹膜内补片治疗儿童复发性腹股沟疝的诊治分析

摘要

Objective To summarize the experiences of treating recurrent pediatric inguinal hernia laparoscopically with home-made stitches.Methods After basal anesthesia and epidural anesthesia,laparoscopic home-made stitching was used for high-ligation of hernia sac,peritonealhemiorrhaphy and intraperitoneal onlay mesh.treating recurrent inguinal hernia.Surface projection ofinner ring of hernia was selected as a needle marker.Results All procedures were successfully completed.The average operative duration was 20 min.Postoperative recovery was rapid that walking resumed at Day 1 post-operation.During a follow-up period of 1 ～ 2 years,there was no onset of recurrent hernia,abdominal pain or intestinal obstruction.Conclusions Laparoscopic home-made stitching is safe,reliable,mini-invasive and curative for recurrent inguinal hernia.It is specially indicated for large hernia.Wider clinicial popularization is urged.%目的 总结腹腔镜下自制缝针腹膜内补片治疗儿童复发性腹股沟疝的方法和经验.方法 基础麻醉加硬膜外麻醉,脐部置镜、脐水平左侧腹直肌外缘置操作钳,疝内环口的体表投影作为缝针进针的标识.在腹腔镜下运用自制带线针及针钩,对32例36侧术后复发腹股沟疝内环口进行高位结扎术、腹膜内加补片固定.结果 32例儿童复发性腹股沟疝均顺利完成手术,平均手术时间20min,术后恢复快,手术后次日即能下床活动,无明显并发症.随访全部病例1～2年,无疝复发、无腹痛及肠梗阻等并发症.结论 腹腔镜下自制缝针腹膜内补片治疗儿童术后复发腹股沟疝,安全可靠,创伤小,疗效好,恢复快,特别适合巨大疝的修补手术,值得临床推广应用.