Modified Single-port Laparoscopic Surgery for Children's Unclosed Processus Vaginalis
Objective To investigate the application value of modified single-port laparoscopic surgery for children's unclosed processus vaginalis by using 30° electroscope,needle forceps and water injection crochet.Methods From August 2021 to December 2022,36 children with unclosed processus vaginalis were treated by modified single-port laparoscopic surgery.Instead of laparoscopy,a 30° electroscope was inserted into the abdominal cavity by the lower umbilical margin,and needle forceps were inserted into the abdominal cavity at the midpoint of the umbilical cord and pubic union.Water injection crochet with 2-0 vascular suture was inserted into the extraperitoneal space through the surface point of the internal inguinal ring.With the assistance of needle forceps,water was injected simultaneously to completely separate the spermatic vessels,vas ductus and the surrounding abdominal wall from the peritoneum around the internal ring.Without puncturing the peritoneum,the 2-0 vascular suture was wrapped around the inner ring opening in the water separation gap and led outside the body to complete the ligation.Results All the 36 cases underwent modified single-port laparoscopic surgery successfully,without conversion to open surgery.The operation time was 5-16 min(mean,9.2 min)in32 unilateral cases and9-23 min(mean,13.4 min)in 4 bilateral cases.One case was lost of follow-up,and the remaining 35 cases were followed up in outpatient clinics for 1-6 months and by telephone for 12-28 months,with a median of 20 months.There were no postoperative scrotal hematoma,testicular atrophy,or incision infection.No recurrence was found.Conclusion Modified single-port laparoscopic surgery for children's unclosed processus vaginalis is safe and feasible.
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