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首页> 外文期刊>Surgical Endoscopy >Laparoscopic solution of a vascular complication occurring during an open procedure in a child.
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Laparoscopic solution of a vascular complication occurring during an open procedure in a child.

机译：儿童开放手术过程中发生的腹腔镜血管并发症。

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Usually the word conversion implies conversion from a laparoscopic procedure to an open procedure to solve complications occurring during laparoscopy. In this article we report a conversion from an open procedure to a laparoscopic one, to treat a vascular complication that occurred during an orchiectomy performed in open surgery. A 2-year-old boy came to our center for a right orchiectomy. The clinical history of this baby showed the presence of a right atrophic testis positioned in the medial part of the inguinal canal, a finding also confirmed by ultrasonography. One of our residents performed a right orchiectomy via an open inguinal procedure. After removing the testis, and before ligating the inner spermatic vessels at the level of the internal inguinal ring, the forceps that held the vessels was inadvertently opened, causing a contraction of the spermatic vessels. Since we were unable to identify the vessels and achieve hemostasis via the inguinal opening, a conversion to laparoscopic surgery was decided. A 10-mm 0 degrees optics was introduced through an umbilical trocar and revealed a large retroperitoneal hematoma along both the inner spermatic vessels and the deferential vessels, for about 3-4 cm from the internal inguinal ring. Two 5-mm trocars were positioned in triangulation and hemostasis was achieved by positioning clips on the vessels at the level of internal inguinal ring and proximally to the hematoma. Surgery lasted 1 hour; the laparoscopic procedure, 25 minutes. The baby was discharged 2 days after surgery. At a 9-month follow-up the clinical and ultrasonographical evaluation was normal. This case clearly shows the usefulness of laparoscopy in pediatric surgery, as well as to solve complications due to open surgery. We think that nowadays the use of laparoscopy should be considered indispensable by every pediatric surgical team.
机译：通常，“转换”一词意味着从腹腔镜手术转换为开放式手术，以解决腹腔镜手术期间发生的并发症。在本文中，我们报告了从开放手术到腹腔镜手术的转变，以治疗在开放手术中进行睾丸切除术期间发生的血管并发症。一个2岁男孩来到我们中心进行右睾丸切除术。该婴儿的临床病史显示位于腹股沟管内侧的右萎缩睾丸存在，超声检查也证实了这一发现。我们的一位居民通过开放腹股沟手术进行了右睾丸切除术。取出睾丸后，在将内部精索血管结扎到腹股沟内环的水平之前，不小心打开了夹持血管的钳子，导致精索血管收缩。由于我们无法识别出血管并无法通过腹股沟开口止血，因此决定改用腹腔镜手术。通过脐带套管针引入了一个10毫米0度的光学元件，该光学元件沿精索内部血管和顺产血管延伸出腹膜后血肿，距腹股沟内环约3-4 cm。将两个5毫米套管针置于三角剖分位置，并通过将夹子固定在腹股沟内环水平和血肿的近端来实现止血。手术持续了1个小时;腹腔镜手术25分钟婴儿在手术后2天出院。在9个月的随访中，临床和超声检查均正常。这个案例清楚地表明了腹腔镜在儿科手术中的有用性，以及解决开腹手术引起的并发症的作用。我们认为，如今，每个儿科手术团队都应将腹腔镜检查视为必不可少的工具。

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