Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique own experience
Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique own experience
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DOI：
10.5114/wiitm.2014.40389
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发表时间：
2014-01-01
影响因子：
1.7
通讯作者：
Patkowski, Dariusz
中科院分区：
文献类型：
--
作者：
Wolak, Przemyslaw K.;Patkowski, Dariusz
简介：经皮内环缝合术（PIRS）是一种腹腔镜缝合方法，即在放置于脐部的望远镜控制下经皮缝合腹股沟内环。目的：评价PIRS技术的应用价值。材料和方法：2008年至2010年，本院55名儿童（39名女孩，16名男孩）采用该方法接受手术。结果：术中发现对侧腹股沟管开放10例，确认脐疝2例。在5例中，由于无法继续腹腔镜手术，必须转为开放手术。1例手术诊断为男性假雌雄同体。复发性腹股沟疝需常规手术治疗1例。其他患儿未表现出疝复发的特征。29例患儿术后行腹股沟管超声检查。23例患儿超声检查未见腹股沟管扩张。在其他6名儿童中，超声检查发现腹股沟管扩张或腹股沟管内存在液体。6例患儿术后3 ~ 6个月内出现腹股沟管周围肿胀、疼痛等症状。结论：腹股沟疝手术采用PIRS程序是一种替代的，有效的，微创的手术方法。腹膜腔的可视化可以发现其他异常，也可以在同一疗程中进行其他手术（如关闭对侧腹股沟管或脐疝手术）。
Introduction: Percutaneous internal ring suturing (PIRS) is a method of laparoscopic hemiorrhaphy, i.e. percutaneous closure of the internal inguinal ring under the control of a telescope placed in the umbilicus.Aim: To evaluate the usefulness of the PIRS technique.Material and methods: Fifty-five children (39 girls and 16 boys) underwent surgery using this method in our institution between 2008 and 2010.Results: In 10 cases the presence of an open inguinal canal on the opposite side was also noted during surgery, and umbilical hernia was recognized in 2 patients. In 5 cases it was necessary to convert to the open surgery because of the inability to continue the laparoscopic procedure. In 1 case, male pseudohermaphroditism was diagnosed during surgery. Recurrent inguinal hernia required a conventional method of surgery in 1 child. Other children did not exhibit the characteristics of hernia recurrence. The inguinal canals were followed up with postoperative ultrasound examination in 29 children. In 23 children, the ultrasound examination showed no dilatation of the inguinal canal. In the other 6 children dilatation of the inguinal canal or the presence of fluid within the inguinal canal was observed during ultrasound. In 6 children symptoms such as swelling and soreness around the inguinal canal developed within 3 to 6 months after surgery.Conclusions: Inguinal hernia surgery using the PIRS procedure is an alternative, effective, minimally invasive method of surgery. Visualization of the peritoneal cavity allows for detection of other abnormalities, as well as for performing other procedures during the same session (such as closing the contralateral inguinal canal or umbilical hernia surgery).