摘要
目的探讨经脐进行单孔多通道腹腔镜下小儿的隐睾下降固定术的可行性并评价治疗效果。方法自09年6月至10月,共13例(14侧)患者接受该手术,均取脐作为操作通道,用切开法进入腹腔,将自制单孔多通道套管经脐置入腹腔,从通道内进腹腔镜及两个腹腔镜器械进行操作。将睾丸及精索血管充分游离后,通过腹股沟管将睾丸固定到肉膜外层,用可吸收线缝合伤口。结果手术均获成功,其中11例行一期隐睾下降固定术,2例因睾丸发育不良行睾丸切除术。套管制作平均时间为3min,通道建立时间为5±2min,手术时间17±7min,术中平均出血30±12ml,术后住院时间3.5±1.1d。术中、术后均无并发症发生,术后2周复查脐部切口无明显疤痕,睾丸位于阴囊内。结论经脐单孔腹腔镜隐睾下降固定术治疗小儿隐睾简单易行、安全有效,但操作难度较常规腹腔镜手术复杂,脐部单孔多通道套管及腹腔镜手术器械有待进一步完善和改进。单孔法创伤更小,几乎无疤痕,是一种具有一定优势的微创手术方法,但须掌握正确的操作方法。
Objective To explore the possibility arid therapeutic effect of cryptorchidism in children by transumbilical single-port laparoscopy. Methods Since June 2009 to October, a total of 13 patients （14 sides） were accepted the surgery, and they were taken the navel as operating channel. First dissect the navel into the abdominal cavity, then put the home-made multi-channel tube through the navel hole into the ab- dominal cavity. From the channel, the laparoscopy and two laparoscopic instruments were put into the abdominal to operate. The testis and the spermatic cord vessels were fullly free, and after that, through the inguinal canal, the testis was pulled out and fixed to the outer of sarcolemma of scrotum. At last, absorption line suture the wound. ~ All the operations were successful, and including 11 cases of decline and fixation of cryptorchidism, and 2 cases of orchiectomy because of testicular hypoplasia. The average time of placing the trocar was 3 minutes. Channel set-up time was 5-2 min, operation time was 17-7 min, average bleeding was 30-12 ml, postoperative hospital stay time was 3.5-1.1 days. No complications occurred after operation and two weeks later no significant scar was appeared at the umbilical incision and the testis stayed in the scrotum. Conclusion The transumbilical single-port laparoscopic technique for the treatment of children with cryptorchidism is simple, safe and effective, but the operation is more difficult and complex than the conventional laparoscopic surgery. The surgical instruments of single-port laparescopy need to be further improved. The single-port method has smaller trauma and almost has no scar, and has certain advantages as a minimally invasive surgical techniques, but are required to master the technique of the operation.
出处
《中华腔镜泌尿外科杂志（电子版）》
2010年第1期6-8,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
腹腔镜
隐睾
单孔
治疗
Laparoscopy
Cryptorchidism
Single-port
Therapy
