CAJ | 학술논문

目的探讨单孔腹腔镜监视下经阴囊入路睾丸固定术治疗高位腹股沟型隐睾症的可行性和效果.方法 2010年8月至2011年7月,23例患儿的27侧高位腹股沟型睾丸在单孔腹腔镜辅助下经阴囊入路完成睾丸固定术,用组织钳通过阴囊横切口经外环进入腹股沟管或腹腔抓住睾丸拖出体外,从精索横断未闭鞘突游离睾丸固定在肉膜外；最后在腹腔镜监视下用自制双钩疝针经皮腹膜外关闭开放鞘突.结果所有27侧睾丸在腹腔镜监视下成功固定在阴囊.手术时间30～90 min,没有手术并发症.随访8～20个月,睾丸均位于阴囊内无回缩、萎缩和腹股沟疝的发生.结论单孔腹腔镜监视下经阴囊腹股沟引降睾丸固定术安全、简便、有效,提供了极好的美容效果.
목적 탐토단공복강경감시하경음낭입로고환고정술치료고위복고구형은고증적가행성화효과.방법 2010년8월지2011년7월,23례환인적27측고위복고구형고환재단공복강경보조하경음낭입로완성고환고정술,용조직겸통과음낭횡절구경외배진입복고구관혹복강조주고환타출체외,종정색횡단미폐초돌유리고환고정재육막외；최후재복강경감시하용자제쌍구산침경피복막외관폐개방초돌.결과 소유27측고환재복강경감시하성공고정재음낭.수술시간30～90 min,몰유수술병발증.수방8～20개월,고환균위우음낭내무회축、위축화복고구산적발생.결론 단공복강경감시하경음낭복고구인강고환고정술안전、간편、유효,제공료겁호적미용효과.
Objective To investigate the feasibility and efficacy of transcrotal approach orchiopexy for high inguinal cryptorchidism under the laparoscopic vision through an umbilical port.Methods From August 2010 to July 2011,23 children with 27 undescended testes in the higher inguinal canal were encountered.Transcrotal access orchiopexy assisted by single-port laparoscopy via the umbilicus was performed.After a transverse incision was made on the scrotum,tissue forceps was inserted into the inguinal canal or abdominal cavity through the scrotum and the external ring,and then the testis was grasped and pulled through extracorporeally.The processus vaginalis was separated off the cord structure to release the testis from cephalad retraction,the testis was fixed within the dartos pouch.Finally,under the laparoscopic guidance,the patent processus vaginalis was closed with a homemade two-hooked core endoneedle percutaneous extraperitoneally.Results All 27 testes were successfully fixed via transcrotal access under the laparoscopic guidance.The operative time was 30-90 minutes.There were no introperative complications.All of the testes maintained at intrascrotal position with no atrophy or recurrent inguinal hernia during a follow-up of 8 to 20 months.Conclusions Transcrotal endoinguinal pull-through orchiopexy with single-port laparoscopy is a safe,effective and feasible procedure.It offers excellent cosmetic outcomes.