Single incision laparoscopic repair for late‐onset congenital diaphragmatic hernia using oval‐shaped multichannel port device (E?Z <scp>ACCESS</scp> oval type)?2?months infantile case of Bochdalek hernia
Single incision laparoscopic repair for late‐onset congenital diaphragmatic hernia using oval‐shaped multichannel port device (E?Z <scp>ACCESS</scp> oval type)?2?months infantile case of Bochdalek hernia
复制标题
使用椭圆形多通道端口装置（E?Z <scp>ACCESS</scp> 椭圆形）单切口腹腔镜修复迟发性先天性膈疝？2 个月婴儿 Bochdalek 疝气病例
DOI：
10.1111/ases.12956
复制
发表时间：
2021
影响因子：
1
通讯作者：
Taguchi Tomoaki
中科院分区：
文献类型：
--
作者：
Ieiri Satoshi;Hino Yuko;Irie Keiko;Taguchi Tomoaki
晚发性先天性腹股沟疝占先天性腹股沟疝的10%-36%。他们有资格进行内窥镜治疗，包括胸腔镜和腹腔镜方法，因为这种类型的患者与新生儿病例相比病情相对稳定。然而，单切口腹腔镜方法尚未报道。我们在此报告一个婴儿的情况下，迟发性腹股沟疝谁接受了单切口腹腔镜修补术使用椭圆形多通道port device.Materials和手术技术一个2个月大的女婴突然发作呼吸困难紫绀，并被诊断为左腹股沟疝（Bochdalek疝）的胸部X线。在胃肠道减压和轻度镇静的保守治疗下，她的呼吸状况变得稳定，我们选择性地计划了腹腔镜修复术。术前增强CT成像发现疝出的器官为胃、脾、胰尾、小肠和右半结肠。患者还患有脐疝，因此我们决定通过该脐疝进行单切口修补术。使用椭圆形多通道输液港器械引入3个穿刺器，并通过轻柔操作复位疝出的器官。使用留置缝线，通过双手针驱动上肢和下肢闭合隔膜缺损。还修复了脐疝。术后过程顺利，无复发recognized.DiscussionWider套管针分离实现了使用椭圆形装置，使针驱动更容易执行。通过使用椭圆形多通道输液港器械和巧妙的针驱动，实现了婴儿腹股沟疝的单切口修复。
IntroductionLate‐onset congenital diaphragmatic hernia constitutes 10%‐36% of congenital diaphragmatic hernias. They qualify for endoscopic treatment including both thoracoscopic and laparoscopic approaches because this type of patient is in relatively stable condition compared with neonatal cases. However, single incision laparoscopic approach has not been reported. We herein report an infantile case of late‐presenting diaphragmatic hernia who underwent single incision laparoscopic repair using an oval‐shaped multichannel port device.Materials and Surgical TechniqueA 2 month old female infant had sudden onset dyspnea with cyanosis and was diagnosed as having left diaphragmatic hernia (Bochdalek hernia) by chest X‐ray. As her respiratory condition became stable under conservative treatment using combination of decompression of the gastrointestinal tract and mild sedation, we electively planned laparoscopic repair. Preoperative enhanced computed tomography imaging found that herniated organs were stomach, spleen, pancreatic tail, small intestine and right colon. The patient also had an umbilical hernia, so we decided to perform single incision repair through this umbilical hernia. Three trocars were introduced using an oval‐shaped multichannel port device and herniated organs were reduced by gentle manipulation. The defect of the diaphragm was closed by bi‐hand needle driving for upper and lower limb using a stay suture. The umbilical hernia was also repaired. Postoperative course was uneventful and no recurrence was recognized.DiscussionWider trocar separation was achieved using the oval‐shaped device, making the needle driving easier to perform. By using an oval‐shaped multichannel port device and ingenuity of needle driving, single incision repair of infant diaphragmatic hernia was enabled.