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目的探讨经脐无瘢痕腹腔镜女性腹股沟斜疝疝囊高位结扎术的手术效果及安全性。方法回顾性分析2012年1月至2015年10月,新疆维吾尔自治区人民医院为35例女性腹股沟斜疝患儿行脐部单孔微型腹腔镜进行疝囊高位缝扎术的临床资料,均为女患儿。本组30例单侧腹股沟斜疝,5例双侧腹股沟斜疝。本组35例女性腹股沟斜疝患儿均进行全身麻醉,于脐上皱褶处3或5 mm小切口,Veress针建立CO_2气腹,置入3或5 mm trocar,置入腹腔镜镜头,进行操作同时观察对侧是否存在隐性。在腹腔镜下于患侧内环相应体表投影处切开皮肤1.5 mm,用带线器腹膜外潜行穿刺进行疝囊颈高位缝扎,切口用创可贴粘住。结果本组35例腹股沟疝女患儿均成功完成经脐部单孔微型腹腔镜手术,手术均获成功,平均手术时间15 min,术中无出血、后腹膜血肿等并发症发生。术后平均住院2.5 d,术后随访6~20个月,无一例复发。结论标准腹腔镜器械较大,且腹壁留有10 mm切口,与传统开放手术相比优越性不突出。经脐部单孔微型腹腔镜女儿童疝囊高位结扎术可靠、创伤小、操作简单、安全、有效,明显缩短患儿住院天数及住院费用,术后恢复快。术后不留瘢痕,这种术式不影响学龄期儿童的上课学习。
Objective To investigate the surgical effect and safety of high lumbar hernia sac transplation via navel scarless laparoscopic female groin. Methods From January 2012 to October 2015, retrospectively analyzed the clinical data of 35 cases of female inguinal hernia with single-hole micro-laparoscopic umbilical hernia sac suture in People’s Hospital of Xinjiang Uyghur Autonomous Region from January 2012 to October 2015, both of them were female Children. The group of 30 cases of unilateral inguinal hernia, 5 cases of bilateral inguinal hernia. The 35 cases of female patients with inguinal hernia were under general anesthesia, umbilical folds at 3 or 5 mm small incision, Veress needle to establish CO_2 pneumoperitoneum, placed 3 or 5 mm trocar, laparoscopic lens, carried out Operation while observing the contralateral existence of hidden. Laparoscopic ipsilateral inner ring corresponding body surface projection cut the skin 1.5 mm, with a line peritonitis extraperitoneal suture high hernia sac suture, incision stick with a band-aid. Results All the 35 patients with inguinal hernia successfully completed the single-hole micro-laparoscopic operation through umbilical cord. The operation was successful. The average operation time was 15 min. No complications such as bleeding and retroperitoneal hematoma occurred during operation. The average postoperative hospital stay was 2.5 days and was followed up for 6 to 20 months without any recurrence. Conclusion The standard laparoscopic instruments are larger and the abdominal wall has a 10 mm incision. Compared with the traditional open surgery, superiority is not prominent. The umbilical single-hole mini laparoscopic hernia hernia sac ligation of high reliability, less trauma, simple, safe and effective, significantly reduce the hospitalization days and hospitalization costs, postoperative recovery fast. No scar after surgery, this technique does not affect school-age children learning.