关键词: 儿童腹股沟疝； ,  , 腹腔镜； ,  , 脐内侧襞； ,  , 巨大疝； ,  , 复发； ,  , 解剖要点

Abstract: Objective     To investigate the clinical effect, safety and advantage of single hole laparoscopic high ligation of hernia sac with large round needle in the treatment of giant inguinal hernia in children.    Methods    A retrospective analysis was conducted on 191 children with giant inguinal hernia treated by single-aperture laparoscopic high ligation of hernia sac with large circular needle in He Xian Memorial Affiliated Hospital of Southern Medical University from January 2017 to June 2023. All cases were treated by single-aperture laparoscopic  suture with large circular needle and secondary suture with fascia closure device, that was 5mm laparoscopic monitoring through the umbilical cord. An ordinary open surgical needle was used to hold a large circular needle in the external projection position of the inner ring opening, and then a surgical suture was used to suture the lower half circumference of the inner ring opening, and the upper half circumference of the inner ring opening was then used to puncture the suture line to form a complete wire ring outside the peritoneum and ligated the hernia sac at a high level, so as to achieve the purpose of closing the hernia ring opening.    Results    High ligation of hernia sac was performed successfully in 191 children under single-hole laparoscopy, and no case needed to be transferred to open operation. Among them, 95 cases of right side, 50 cases of left side and 46 cases of bilateral were diagnosed before surgery, and 56 cases of contralateral occult hernia were found during operation. The mean operation time of unilateral hernia was 18min (10-35min), and that of bilateral hernia was 25min (18-45min). The average length of stay was 16h. Intraoperative spermatic vascular injury resulted in 2 cases of extraperitoneal hematoma, one recrudescence was found during the postoperative follow-up time in 1-15 months.    Conclusions    Single-hole laparoscopic high ligation of hernia sac with large round needle is safe and effective in the treatment of giant inguinal hernia in children. The curved structure of the large round needle is more suitable for the suture operation habits of surgeons, can reduce the surgical complications, and the materials are simple and cheap, which is worthy of clinical application.

Key words:  Inguinal hernia in children; ,  Laparoscopy; ,  Medial umbilical fold; ,  Giant hernia, Recrudescence; ,  ,  Anatomical key points