A traceless laparoscopic hernial sac high ligation operation method

Abstract

The application discloses a kind of traceless laparoscopic hernial sac high position ligation operation method, this method includes: establishing umbilical observation and operation channel;Foldable absorbable surgical suture is placed into syringe needle lumen after being folded, and is vertically punctured in the body surface of the inner ring mouth of the affected side under the monitoring of laparoscope, and is passed to the inside through the gap between hernial sac and hernia covering cover, and is punctured into abdominal cavity after passing through the front of vas deferens, and the suture is led out using grabbing forceps;Retreat needle to the outside after passing through to the needle point into abdomen after the inner ring mouth;Make needle tip enter loop and tighten by lifting and pulling suture skin end, then send the needle tube into abdominal cavity by the needle tube of cavity puncture needle with prepositioned non-absorbable silk thread, and withdraw puncture needle and syringe after grabbing line;After confirming that there is no omental incarceration, exhaust pneumoperitoneum, remove shell card and suture umbilical incision;Finally, silk thread is led out through needle hole and knotted, and high position ligation of hernial sac is completed.The application achieves the same therapeutic effect as the currently prevailing high position ligation of hernial sac in children in clinic, reduces medical consumables, and achieves the cosmetic effect of no trace on abdomen.

Description

Technical Field

[0001] This invention relates to the field of minimally invasive surgical techniques, and in particular to a scarless laparoscopic high ligation method for hernia sac. Background Technology

[0002] Inguinal hernia is a common pediatric surgical condition, and laparoscopic high ligation of the hernia sac is currently the prevalent treatment method. Existing techniques typically employ specialized hernia repair instruments (such as hernia hooks and ligators). However, these specialized instruments are often expensive, leading to high medical consumable costs. Furthermore, traditional external puncture methods usually require creating additional puncture or needle holes in the groin area, leaving visible scars post-operatively, which may not meet patients' aesthetic requirements. Summary of the Invention

[0003] The present invention aims to at least partially solve the technical problems in related technologies. Therefore, the first objective of the present invention is to provide a scarless laparoscopic high ligation method for hernia sacs, which utilizes common medical consumables instead of expensive specialized instruments, significantly reducing medical costs while ensuring treatment effectiveness and achieving a scarless cosmetic effect on the abdomen.

[0004] To achieve the above objectives, the present invention is implemented through the following technical solution: A scarless laparoscopic high ligation method for hernia sac includes: Establish an observation and operation channel for the umbilicus; The absorbable surgical suture is folded in half and inserted into the lumen of a syringe needle. Under laparoscopic monitoring, the needle is inserted vertically into the surface of the internal ring of the affected side. It first passes medially between the hernia sac and the hernia cover, then passes between the vas deferens and the hernia sac before piercing the peritoneum to enter the abdominal cavity. The absorbable surgical suture is then pulled out from the needle tube using laparoscopic grasping forceps. The needle is withdrawn to the inner incision point and then moved outwards to the exit point to enter the abdominal cavity; Lift the outer end of the absorbable surgical suture, allowing the needle tip inside the abdominal cavity to enter the coil of the absorbable surgical suture. Tighten the absorbable surgical suture, and insert a puncture needle with a lumen pre-placed non-absorbable surgical suture into the abdominal cavity through the syringe needle tube. After grasping the non-absorbable surgical suture, withdraw the puncture needle with a lumen and the syringe needle. After checking that there is no retina around the non-absorbable surgical suture, deflate the pneumoperitoneum, remove the shell clip, and suture the umbilical incision. The absorbable surgical suture is pulled up to bring the abdominal end of the non-absorbable surgical suture out of the needle hole, and the hernia sac is tied and knotted, thus completing the operation.

[0005] Preferably, the absorbable surgical suture is a PDS suture.

[0006] Preferably, the PDS line is a PDS3# line.

[0007] Preferably, the catheter-guided puncture needle is an indwelling arteriovenous catheter.

[0008] Preferably, the non-absorbable surgical suture is a No. 4 suture.

[0009] Preferably, the syringe needle is a 20ml syringe needle.

[0010] This invention has at least the following technical effects: This invention provides a scarless laparoscopic high ligation method for hernia sacs. The procedure is performed using a 20ml syringe needle, an indwelling arterial / venous catheter, and PDS #3 and #4 silk sutures, achieving the same therapeutic effect as currently popular pediatric high ligation methods. Furthermore, by using common medical consumables instead of specialized instruments, the cost of medical supplies is significantly reduced. In addition, the single-incision approach through the umbilicus and the removal of the ligation suture through the needle hole avoids additional incisions in the groin area, achieving a scarless cosmetic result on the abdomen.

[0011] Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Attached Figure Description

[0012] Figure 1 This is a flowchart of a scarless laparoscopic high ligation procedure for hernia sac according to an embodiment of the present invention. Detailed Implementation

[0013] The following describes this embodiment in detail. Examples of the embodiments are shown in the accompanying drawings, wherein the same or similar reference numerals denote the same or similar elements or elements having the same or similar functions throughout. The embodiments described below with reference to the accompanying drawings are exemplary and intended to explain the invention, and should not be construed as limiting the invention.

[0014] The following describes a method for high ligation of the hernia sac using a scarless laparoscopic technique, with reference to the accompanying drawings.

[0015] Figure 1 This is a flowchart illustrating a method for high ligation of the hernia sac using scarless laparoscopic techniques, according to an embodiment of the present invention. Figure 1 As shown, the method includes: Step S1: Establish an observation and operation channel for the umbilicus.

[0016] Specifically, an observation and operation channel for the umbilicus is established under laparoscopic monitoring, serving as the sole entry point for observation and operation.

[0017] Step S2: Fold the absorbable surgical suture in half and insert it into the lumen of a syringe needle. Under laparoscopic monitoring, insert the needle vertically into the surface of the internal inguinal ring on the affected side. Pass it medially between the hernia sac and the hernia tegmentum, then pass it between the vas deferens and the hernia sac before piercing the peritoneum to enter the abdominal cavity. Use laparoscopic forceps to remove the absorbable surgical suture from the needle.

[0018] Specifically, the PDS3# suture (medical surgical suture) is folded in half and inserted into the lumen of a 20ml syringe needle. Under laparoscopic monitoring, the needle is inserted vertically into the surface of the internal inguinal ring on the affected side. The needle first passes medially between the hernia sac and the external tegmentum, then carefully passes between the vas deferens and the hernia sac, before piercing the peritoneum into the abdominal cavity. At this point, the PDS3# suture is removed from the needle using laparoscopic forceps.

[0019] Step S3: Withdraw the needle to the inner incision and then move it outward to the exit point to enter the abdominal cavity.

[0020] Specifically, after completing step S2, the needle is withdrawn to the inner incision, then moved outward until it reaches the exit point and re-enters the abdominal cavity.

[0021] Step S4: Lift the outer end of the absorbable surgical suture so that the needle tip inside the abdominal cavity enters the coil of the absorbable surgical suture. Tighten the absorbable surgical suture. Insert the puncture needle with a lumen pre-placed with non-absorbable surgical suture into the abdominal cavity through the syringe needle tube. After grasping the non-absorbable surgical suture, withdraw the puncture needle with a lumen and the syringe needle.

[0022] Specifically, lift the outer end of the PDS3# suture so that the needle tip inside the abdominal cavity enters the coil formed by the PDS3# suture. Then tighten the PDS3# suture. Next, insert the indwelling arteriovenous catheter with No. 4 silk thread into the abdominal cavity through the syringe needle of a 20ml syringe. Grasp the No. 4 silk thread with forceps, and then withdraw the indwelling arteriovenous catheter and the 20ml syringe needle.

[0023] Step S5: After checking that there is no retina around the non-absorbable surgical suture, deflate the pneumoperitoneum, remove the cassette, and suture the umbilical incision.

[0024] Specifically, after checking that there is no retina attached around the No. 4 silk thread, the pneumoperitoneum is emptied, the shell card is removed, and the umbilical incision is sutured.

[0025] Step S6: Pull up the absorbable surgical suture and pull the abdominal end of the non-absorbable surgical suture out of the needle hole, tie a knot to ligate the hernia sac, and the operation is complete.

[0026] Specifically, pull the PDS3# thread upwards, pull the abdominal end of the No.4 silk thread out of the needle hole, then tie a knot to ligate the hernia sac, and the operation is complete.

[0027] It should be noted that the absorbable surgical suture used is PDS suture (polydioxanone suture). Utilizing its relatively hard material and strong support properties, it can smoothly pass through and be pushed out of the lumen of a 20ml syringe needle, solving the problem of ordinary soft sutures being difficult to adapt to rigid needles. Furthermore, as an absorbable material, PDS sutures do not require secondary removal if they remain in the body after the guiding task, reducing the risk of foreign body reactions. In this embodiment, the PDS suture is a #3 suture, which balances sufficient tensile strength with suitable needle compatibility. Compared to thinner sutures, #3 sutures are less prone to breakage when pulled in the abdominal cavity and can effectively withstand the tension during hernia sac ligation; compared to thicker sutures, it can be inserted more smoothly into the narrow lumen of a 20ml syringe needle, ensuring smooth operation.

[0028] Furthermore, the catheter-guided puncture needle is an arteriovenous indwelling needle. Utilizing its unique double-layer structure of a steel needle core and an outer soft cannula, the soft cannula effectively protects the non-absorbable surgical suture from being cut by the sharp needle tip during the process of penetrating the peritoneum and entering the abdominal cavity. Simultaneously, the smooth lumen and moderate hardness of the indwelling needle facilitate the precise introduction of the No. 4 silk suture into the abdominal cavity, and the needle is not easily deformed during withdrawal, ensuring a high success rate for suture placement. In addition, the non-absorbable surgical suture is No. 4 silk, which has a high surface friction coefficient and strong knotting ability, ensuring that the knot is not easily loosened when ligating the internal ring of the hernia sac, providing a reliable and permanent ligation effect. At the same time, the No. 4 silk suture is tough and not easily cut during the process of exiting the abdominal cavity through the skin needle hole, ensuring the safety of the surgery.

[0029] Furthermore, the syringe needle uses a 20ml syringe needle with a moderate diameter, which can accommodate the folded PDS3# suture while ensuring sufficient rigidity and sharpness when the needle passes through the subcutaneous tissue, making it easy for doctors to accurately control the puncture path; in addition, the 20ml syringe needle is a clinically common consumable and does not require customization, further reducing the cost of surgery.

[0030] In this embodiment, a 20ml syringe needle is used as the puncture guide, along with an indwelling arterial or venous catheter as the delivery channel, completely avoiding the use of clinically specialized hernia hooks (Endoclose) or ligation devices (Endoloop). Both the syringe needle and the indwelling catheter are common, low-cost clinical consumables, significantly reducing the cost of consumables per surgery, making it particularly suitable for primary hospitals or medical insurance payment environments sensitive to consumables. Furthermore, the single umbilical observation channel combined with a single needle puncture path on the body avoids the additional puncture holes or scars left in the groin area by traditional open surgery or traditional laparoscopic external puncture methods. After ligation, the knot can be buried subcutaneously or within the needle puncture site, leaving no visible incision on the abdominal wall except for the natural fold of the navel, achieving excellent cosmetic results. Furthermore, this embodiment employs a safe and reliable dual-line guidance mechanism, namely a split design using absorbable suture guidance and non-absorbable suture ligation. The high rigidity and easy-to-push properties of PDS suture (absorbable) are utilized to complete the complex extraperitoneal passage and coil construction; the high tensile strength and stable knotting properties of No. 4 silk suture are used to complete the final high ligation of the hernia sac. This division of labor ensures both the smoothness of the puncture process and the long-term effectiveness of the ligation, reducing the operational risks of suture interruption or postoperative recurrence.

[0031] In summary, this invention achieves the same therapeutic effect as the currently popular pediatric hernia sac high ligation by using a 20ml syringe needle, an arteriovenous indwelling needle, and PDS 3# and 4# silk sutures to ligate the hernia sac high under laparoscopic monitoring. However, this invention reduces medical consumables and also achieves a scarless cosmetic effect on the abdomen.

[0032] The above embodiments are only used to illustrate the technical solutions of the present invention, and are not intended to limit it. Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features. Such modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A method for high ligation of the hernia sac using scarless laparoscopic techniques, characterized in that, include: Establish an observation and operation channel for the umbilicus; The absorbable surgical suture is folded in half and inserted into the lumen of a syringe needle. Under laparoscopic monitoring, the needle is inserted vertically into the surface of the internal ring of the affected side. It first passes medially between the hernia sac and the hernia cover, then passes between the vas deferens and the hernia sac before piercing the peritoneum to enter the abdominal cavity. The absorbable surgical suture is then pulled out from the needle tube using laparoscopic grasping forceps. The needle is withdrawn to the inner incision point and then moved outwards to the exit point to enter the abdominal cavity; Lift the outer end of the absorbable surgical suture, allowing the needle tip inside the abdominal cavity to enter the coil of the absorbable surgical suture. Tighten the absorbable surgical suture, and insert a puncture needle with a lumen pre-placed non-absorbable surgical suture into the abdominal cavity through the syringe needle tube. After grasping the non-absorbable surgical suture, withdraw the puncture needle with a lumen and the syringe needle. After checking that there is no retina around the non-absorbable surgical suture, deflate the pneumoperitoneum, remove the shell clip, and suture the umbilical incision. The absorbable surgical suture is pulled up to bring the abdominal end of the non-absorbable surgical suture out of the needle hole, and the hernia sac is tied and knotted, thus completing the operation.

2. The method as described in claim 1, characterized in that, The absorbable surgical suture is a PDS suture.

3. The method as described in claim 2, characterized in that, The PDS line is designated as PDS3# line.

4. The method as described in claim 1, characterized in that, The catheter-guided needle is an indwelling arteriovenous catheter.

5. The method as described in claim 4, characterized in that, The non-absorbable surgical suture is a No. 4 suture.

6. The method as described in claim 1, characterized in that, The syringe needle is a 20ml syringe needle.

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