Hu Weize,Dai Yujian,Zheng Huiming,et al.Single-port laparoscopic percutaneous extraperitoneal closure using self-made hernia needle for pediatric inguinal hernia[J].Journal of Clinical Pediatric Surgery,,22():278-282.[doi:10.3760/cma.j.cn101785-202110032-014]
Single-port laparoscopic percutaneous extraperitoneal closure using self-made hernia needle for pediatric inguinal hernia
- Keywords:
- Laparoscopes; Hernia; Abdominal; Ligation; Groin; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the method and efficacy of single-port laparoscopic percutaneous extraperitoneal closure using self-made hernia needle for pediatric inguinal hernia.Methods From September 2018 to June 2020,clinical data were retrospectively reviewed for 715 children of pediatric inguinal hernia undergoing single-port laparoscopic percutaneous extraperitoneal closure using self-made hernia needle.There were 580 boys and 135 girls.The involved side was unilateral (n=687) and bilateral (n=28).Among 580 boys,the involved side was right (n=325),left (n=240) and bilateral (n=15);Among 135 girls,the involved side was right (n=62),left (n=60) and bilateral (n=13).Proportion of gender,proportion of sideness,operative duration,intraoperative volume of hemorrhage and proportion of children with patent processus vaginalis or recessive hernia detected intraoperatively were analyzed.Results All children underwent laparoscopy without any conversion into open surgery.A total of 320 cases of contralateral non-closure of processus vaginalis or latent hernia were detected intraoperatively,accounting for about 46.5% of all children,including 140 boys (43.1%,140/325) at right side,115 boys (47.9%,115/240) at left side,33 girls (53.2%,33/62) at right side and 32 girls (53.3%,32/60) at left side.During operation,35 boys (approximately 4.9%,35/715) failed to pass hernia needle due to inner peritoneal folds of inner ring orifice.An auxiliary grasping forceps was placed about 3 cm below umbilicus or beside umbilicus to assist operation.Operative duration:unilateral (10-15) min,average 12 min,bilateral (15-21) min,average 17 min.The intraoperative blood loss was (0-1) ml.After operation,children could resume a liquid diet after anesthesia.After day surgery,they were discharged within 24h after admission.Without injury to spermatic cord,vas deferens or inferior abdominal artery,there was no postoperative swelling of scrotum.During a follow-up period of 18.3(12-33) months,there were recurrence (n=2) and suture node reaction (n=1).No testicular atrophy,iatrogenic cryptorchidism or postoperative hydrocele occurred.Conclusion With a simultaneous treatment of contralateral processus vaginalis or latent hernia,single-port laparoscopic percutaneous extraperitoneal closure using self-made hernia needle for pediatric inguinal hernia offers the advantages of minimal trauma,faster recovery,lower recurrence rate and pleasant incision.It is worthy of wider clinical promotions.
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Memo
收稿日期:2021-10-24。
基金项目:福建省自然科学基金(2020J011285)
通讯作者:郑辉明,Email:zhenghm123@126.com