What operation method is good for children's hydrocele?

What operation method is good for children's hydrocele?

1. Pathogenesis and related anatomical knowledge of hydrocele in children:

1. Pathogenesis of hydrocele in children: When the testis descends from the retroperitoneal space, the sheath process consisting of two layers of peritoneum also enters the scrotum through the inguinal canal. Under normal circumstances, before and after the birth of the fetus, most of the sheath process is completely closed. If it is not closed, the liquid in the abdominal cavity can squeeze into the scrotum through the unclosed sheath process when the child cries hard, forming hydrocele of the child's sheath.

2. Related anatomical knowledge: The internal opening of the unclosed sheath process (seen from the abdominal cavity) is called the internal ring. The unclosed sheath process is tubular and clings to the blood vessels supplying testis and vas deferens, which are the main structures of spermatic cord.

Second, the operation method is introduced:

1. Traditional operation: Find the spermatic cord from the incision outside the abdominal cavity (the surface of the spermatic cord in the inguinal region), separate the "sheath-like process tube" from the spermatic cord, and tie it to death at the root (i.e. the inner ring), so that the fluid in the abdominal cavity will no longer flow out of the sheath-like process tube to form effusion, thus curing the hydrocele of the children's sheath. Disadvantages of this method: 1. When the sheath-like protruding tube (also called hernia sac) is separated from the spermatic cord, it is easy to damage the blood vessels and vas deferens that constitute the spermatic cord, resulting in testicular atrophy's infertility (the semen that has damaged the vas deferens cannot be exported). 2. Scar healing in the operating area leads to tissue adhesion in the operating area, which may cause testicular elevation (cryptorchidism in severe cases) or decrease the range of testicular activity (caused by adhesion of levator testis). Ligation line is easy to loosen, and hydrocele in children recurs.

2. Laparoscopic minimally invasive surgery: directly suture and ligate the inner mouth of the "sheath-like process tube" (also called "inner ring") in the abdominal cavity, and only use a thread with the same thickness as the hair to make a needle. After the operation is completed, it will not affect any anatomical spermatic vessels and vas deferens. At the same time, if the child has hydrocele on both sides, it can be done at the same time, unlike traditional surgery, which requires another incision. Ligation does not loosen, so it rarely recurs.

Third, the advantages of traditional surgery and laparoscopic minimally invasive surgery: From the introduction of the above surgical methods, we have seen the advantages and disadvantages of the two. In addition, laparoscopic minimally invasive surgery has the following advantages: 1, small incision (only 3 mm), hidden (in the navel), so beautiful. 2, minimally invasive, quick recovery, free movement after three days of discharge.

The pathogenesis of hernia in children is similar to that of hydrocele in children, and the operation method is the same.