Single‐incision laparoscopic percutaneous extraperitoneal closure (SILPEC) for inguinal hernia with prolapsed ovary
Single‐incision laparoscopic percutaneous extraperitoneal closure (SILPEC) for inguinal hernia with prolapsed ovary
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单切口腹腔镜经皮腹膜外封堵术（SILPEC）治疗腹股沟疝伴卵巢脱垂
DOI：
10.1007/s00464-021-08777-4
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Chiyoe Shirota; Takahisa Tainaka; Wataru Sumida; Kazuki Yokota; Satoshi Makita; Hizuru Amano; Masamune Okamoto; Aitaro Takimoto; Akihiro Yasui; Yoichi Nakagawa; Akinari Hinoki; Hiroo Uchida
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文献类型：
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作者：
J. Shi Jialiang;Ghasiya Piyush;Sasahara Kazutoshi;森叶人，白松(磯口)知世，高橋宏知;Hajime Mochizuki and Kohji Shibano;Chiyoe Shirota; Takahisa Tainaka; Wataru Sumida; Kazuki Yokota; Satoshi Makita; Hizuru Amano; Masamune Okamoto; Aitaro Takimoto; Akihiro Yasui; Yoichi Nakagawa; Akinari Hinoki; Hiroo Uchida
背景大多数报道腹腔镜下卵巢脱垂疝手术结果的大样本研究是基于腹膜内闭合，而腹膜外闭合的研究样本量有限。我们积极使用的单切口腹腔镜经皮腹膜外闭合（SILPEC）技术，并获得了良好的结果，我们在本文report.MethodsWe回顾性分析谁在我们的机构接受腹腔镜手术腹股沟疝的患者。根据术前或术中诊断的疝伴脱垂卵巢，将其回顾性分为两组，分别为脱垂组和非脱垂组。对数据进行统计学分析，p < 0.05视为具有统计学意义。结果研究期间共有771名受试者接受了SILPEC，其中400名女孩。其中，63名女孩被诊断患有卵巢脱垂疝。在所有病例中，SILPEC均通过单个端口成功进行，只有一个例外，即将镊子直接插入右下腹以拉起卵巢。脱垂组的手术持续时间并不高于非脱垂组。在SILPEC手术中，63例患者中有38例仅通过腹股沟区的外部压迫成功将卵巢恢复到腹腔中。其余25例采用腹股沟区外压及钳牵引圆韧带将卵巢复位入腹腔。这些情况下，没有一个未能返回到ovaries.ConclusionOur研究结果表明，SILPEC可以安全地进行治疗卵巢脱垂腹股沟疝。由于圆韧带较短，卵巢和输卵管靠近腹股沟内环，因此手术需要小心牵拉圆韧带。
BackgroundMost studies reporting the outcomes of laparoscopic ovarian prolapsed hernia operations with large sample sizes are based on intracorporeal closure, while studies on extraperitoneal closure have limited sample sizes. We proactively used the single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) technique and obtained favorable outcomes, which we report in this paper.MethodsWe retrospectively reviewed patients who had undergone laparoscopic surgery for inguinal hernia at our institution. They were retrospectively classified into two groups based on the pre- or intraoperative diagnosis of hernia with a prolapsed ovary, namely the prolapse group and the non-prolapse group, respectively. The data were statistically analyzed andp< 0.05 was considered statistically significant.ResultsA total of 771 subjects underwent SILPEC during the study period, including 400 girls. Among them, 63 girls were diagnosed with an ovarian prolapsed hernia. SILPEC was successfully performed through a single port in all cases, with a single exception, in whom the forceps was inserted directly through the right lower quadrant to pull up the ovary. The duration of surgery in the prolapse group was not higher than that in the non-prolapse group. During the SILPEC surgery, the ovaries were successfully reverted into the abdominal cavity by external compression of the inguinal area alone in 38 of the 63 patients. In the remaining 25 cases, the ovaries were reverted into the abdominal cavity by external compression of the inguinal area and traction of the round ligament with forceps. None of these cases failed to return to the ovaries.ConclusionOur study results indicate that SILPEC may be performed safely for the treatment of ovarian prolapsed inguinal hernia. Since the ovary and fallopian tube are close to the internal inguinal ring due to the short round ligament, the procedure requires careful suturing with traction of the round ligament.