Application of Extracorporeal Suture Traction of Round Ligament of the Uterus Assisted Two-port Laparoscopic Internal Ring Closure in Pediatric Ovarian Sliding Hernia
10.3969/j.issn.1009-6604.2025.08.007
- VernacularTitle:体外丝线牵拉子宫圆韧带辅助两孔腹腔镜内环缝合在儿童卵巢滑疝中的应用
- Author:
Xuelai LIU
1
;
Jingxuan SUN
1
;
Jianji XU
1
Author Information
1. 首都医科大学附属首都儿童医学中心普通外科,北京 100020
- Publication Type:Journal Article
- Keywords:
Extracorporeal suture traction;
Round ligament of the uterus;
Internal ring suturing;
Ovary;
Sliding hernia
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(8):485-488
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the safety and feasibility of extracorporeal suture traction of round ligament of the uterus assisted two-port laparoscopic internal ring closure in the treatment of pediatric ovarian sliding hernia.Methods From September 2019 to September 2024,57 children with ovarian sliding hernia underwent extracorporeal suture traction of round ligament of the uterus assisted two-port laparoscopic internal ring closure.Under the guidance of single-port umbilical laparoscopic monitoring,a 2-0 suturing needle with thread was inserted through the opposite internal ring and used to suture the round ligament of the uterus at the affected side's internal ring.The needle was passed through and exited near the entry point,and the extracorporeal suture traction was used to pull the ovary(and part of the fallopian tube)back into the abdominal cavity from the inguinal canal,maintaining the suture tension to prevent the ovary and fallopian tube from re-entering the internal ring.The internal ring was fully exposed.A 2-0 suturing needle with thread was inserted at the affected side(2-3 cm from the internal ring)to perform a circular suture of the peritoneum at the internal ring.The internal ring was closed at the level of internal ring orifice.Results All the 57 cases of ovarian sliding hernia were confirmed to be unilateral,with 18 cases on the right side(including 12 cases of pure ovarian sliding hernia and 6 cases of ovarian and fallopian tube sliding hernia)and 39 cases on the left side(including 22 cases of pure ovarian sliding hernia and 17 cases of ovarian and fallopian tube sliding hernia).The average surgery time was(22.5±2.5)min.All the patients were discharged within 6 h postoperatively and no complications were noted.A total of 49 patients were followed up for6-20 months(mean 9.5 months),with 21 cases followed for more than 12 months.No complications such as incision infection,recurrence of hernia,or Nuck's cyst were observed.Ultrasonic examinations showed normal bilateral ovarian blood flow.Conclusion For pediatric ovarian sliding hernia,extracorporeal suture traction of round ligament of the uterus assisted two-port laparoscopic internal ring closure can effectively retract the ovary(and part of the fallopian tube)from the inguinal canal back into the abdominal cavity,fully exposing the normal anatomical form of the internal ring,with the characteristics of safety and feasibility.
