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目的探讨脐正中襞在腹腔镜治疗小儿腹股沟斜疝中的应用价值。方法2004年1月~2005年8月,我们应用腹腔镜疝囊高位结扎及脐正中襞覆盖疝环口治疗105例腹股沟斜疝(其中嵌顿疝32例,双侧疝25例,开放手术后复发疝6例)。两孔或三孔法,腹腔镜下找到患侧内环口,带线针缝合内环口内半周腹膜和外半周腹膜,使疝环口成一荷包缝合,打结后用带线针将脐正中襞缝合覆盖疝内环口及周围。结果105例均在腹腔镜下完成手术,单侧疝手术时间10~25 m in,平均15 m in;双侧疝手术时间20~35 m in,平均25 m in。术中无出血,住院2~3 d。术后恢复顺利,无肠粘连、腹腔感染、阴囊血肿。105例随访5~24个月,平均18个月,无复发。结论应用腹腔镜疝囊高位结扎及脐正中襞覆盖疝内环口治疗小儿腹股沟疝是安全可行的,且创伤小,恢复快,住院时间短,不易复发。
Objective To investigate the value of median navel for laparoscopic treatment of infantile inguinal hernia. Methods From January 2004 to August 2005, we treated 105 cases of inguinal hernia with high laparoscopic hernia sac ligation and umbilical median 襞 hernia ring (including 32 cases of incarcerated hernia and 25 cases of bilateral hernia after open surgery 6 cases of recurrent hernia). Two-hole or three-hole method, laparoscopic find the ipsilateral inner ring mouth, with a line needle suture the inner half of the peritoneum and peritoneum outer peritoneum, hernia ring mouth into a purse suture, tied with a needle after the umbilical line in the middle 襞Suture covering hernia and around the mouth. Results All the 105 cases underwent laparoscopic surgery. The operation time of unilateral hernia was 10-25 mins with an average of 15 m in. The operation time of bilateral hernia was 20-35 mins with an average of 25 m in. No bleeding during surgery, hospitalized 2 ~ 3 d. Postoperative recovery was successful, no intestinal adhesion, abdominal infection, scrotal hematoma. 105 cases were followed up for 5 to 24 months, an average of 18 months, no recurrence. Conclusion The application of laparoscopic high ligation of hernia sac and umbilical midline hernia in the treatment of children with inguinal hernia is safe and feasible, and less trauma, faster recovery, shorter hospital stay, difficult to relapse.