微型腹腔镜下内环高位结扎术联合包皮环套术治疗小儿腹股沟斜疝及包茎.docVIP

微型腹腔镜下内环高位结扎术联合包皮环套术治疗小儿腹股沟斜疝及包茎 司徒升 余健雄 周沛华 方万强 （开平市中心医院，广东 江门，529300） 【摘要】 目的 探讨微型腹腔镜下内环高位结扎术联合包皮环套术治疗小儿腹股沟斜疝及包茎的可行性及优点。方法 对10例小儿斜疝患儿先施行微型腹腔镜下内环高位结扎术，随后对有包茎的患儿同时行包皮环套术。结果 全部患儿均顺利完成腹腔镜下内环高位结扎术和包皮环套术。术后恢复顺利，随访1至9个月斜疝无复发。讨论 微型腹腔镜下内环高位结扎治疗小儿腹股沟斜疝较传统手术方法具有创伤小、美观、手术操作简便、手术时间短、并发症少、术后恢复快等优点，联合包皮环套术使术后容易清洗、护理。避免了二次手术和麻醉，减少了治疗费用，减轻了患儿的痛苦，是安全可行的。 【关键词】腹腔镜；疝；腹股沟；包茎；儿童 Microlaparoscopic Herniotomy for Indirect Inguinal Hernia Association Circumcision Rings Remove Prepuce Therapy For Indirect Inguinal Hernia And Phimosis In Children SITU sheng, YU jianxiong,ZHOU peihua, FANG wanqiang.Kaiping City Center Hospital,Kaiping 529300,China Objective : To explore the possibility and excellence of microlaparoscopic herniotomy for indirect Inguinal hernia association circumcision rings remove prepuce therapy for indirect inguinal hernia and phimosis in children. Methods:9 cases of indirect inguinal hernia In Children were to perform microlaparoscopic hernia sac high ligation frist ,then were to perform circumcision rings remove prepuce. Results: All of Children completed successfully microlaparoscopic herniotomy and circumcision rings remove prepuce ,and recovered well. No recurrence was found at a follow up 1-9 months. Conclusions: microlaparoscopic hernia sac high ligation for indirect Inguinal hernia has smaller trauma then open operation,and moer beautiful, technique simple and short time, decreased complication. Recovery quickly. Association circumcision rings remove prepuce nursing easy postoperative. To avoid repeated therapy. Decreased the expense and painful.It is operation safety. 　　【Key words】　Microlaparoscopic; Inguinal hernia；Circumcision Rings; phimosis ;Child 小儿腹股沟斜疝是常见的小儿疾病，包茎更是多见。我们自2005年10月开始尝试采用微型腹腔镜下内环高位结扎术与包皮环套术联合手术，取得了良好的效果，现报告如下。 1 临床资料 1.1 一般资料 本组共10例患儿，年龄1－7岁，左侧斜疝3例，右侧7例。其中复发疝1例，巨大疝1例，术中发现对侧隐性疝2例，均有包茎存在，有5例包皮下积存包皮垢。 1.2 手术方法 1.2.1 腹腔镜采用器械： 5mm微型腹腔镜，3mm操作钳，雪橇型带线针及钩针（1）。 1.2.2 操作（1）麻醉:氯胺酮加静脉复合麻醉。（2）体位:头低脚高位20°～30°。（3）取脐缘处切口5mm，穿刺CO 2 气腹，压力8～9mmHg，穿入5mm