Study on the clinical value of sewing up incision by elastic snell needle in laparoscopic operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 FANGXiang , MAIGang , LIUZhongliang , ZHANGYuetian , ZHENGBenbo , LIUZheng

Department of General Surgery, The People's Hospital of Deyang City, Deyang, Sichuan 618000, P.R.China;

Corresponding author：

FANGXiang, Email: fangxiang76111@163.com

Keywords：

celoscope; elastic snell needle; incisional hernia; incisional bleeding; way of suturation

DOI：

10.7507/1007-9424.201605078

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To find a simple, practical and cheap way in suturation to prevent incision complications after celoscope surgery. Methods Using the elastic snell needle to stitch small incision under laparoscopy. Chosed 3 120 cases using the elastic snell needle to stitch stratified suturation as research group, and 3 120 cases by using trditional arc shaped needle in celoscope surgery as control group. The incident rate of incisional hernia and incision bleeding among groups were compared. Results In research group, the incident rate of incision bleeding was 0.16%, among which was 0.15% in epigastrium group, 0.18% in hypogastrium group, while in control group, the incident rate of incision bleeding was 0.68%, among which was 0.64% in epigastrium group, 0.70% in hypogastrium group. The incident rate of incision bleeding was obviously decreased (P＜0.05), and the incident rate of incision bleeding in hypogastrium group was obviously decreased as well (P＜0.05), compared research group and control group. In research group, the incident rate of incisional hernia was 0.07%, among which was 0 in epigastrium group, 0.12% in hypogastrium group, 0.15% in gerontism group, while in control group, the incident rate of incisional hernia was 0.44%, among which was 0.24% in epigastrium group, 0.59% in hypogastrium group, 0.99% in gerontism group, and the incident rate of incisional hernia after surgery was obviously decreased (P＜0.05), the incident rate of incisional hernia after surgery in hypogastrium group was obviously decreased as well (P＜0.05), comparing research group and control group. Conclusions Using the elastic snell needle to stitch small incision under laparoscopy, the peritoneal layer and muscular layer can be apposition sutured in the case without prolonging incision and costing more, hidden hernia and abdominal wall defects located at the incision can be found, ligation and stitched, thereby the incident rate of incisional hernia and incisional bleeding after celoscope surgery are significantly reduced.

Citation： FANGXiang, MAIGang, LIUZhongliang, ZHANGYuetian, ZHENGBenbo, LIUZheng. Study on the clinical value of sewing up incision by elastic snell needle in laparoscopic operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(1): 59-63. doi: 10.7507/1007-9424.201605078 Copy

1.	Azevedo JI, Azevedo OC, Miyahira SA,et al. Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review. Surg Endosc, 2009, 23(7): 1428-1432.
2.	Fear RE. Laparoscopy: a valuable aid in gynecologic diagnosis. Obstet Gynecol, 1968, 31(3): 297-309.
3.	Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists. Obstet Gynecol, 1994, 84(5): 881-884.
4.	Nassar AH, Ashkar KA, Rashed AA,et al. Laparoscopic cholecystectomy and the umbilicus. Br J Surg, 1997, 84(5): 630-633.
5.	Azurin DJ, Go LS, Arroyo LR,et al. Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. Am Surg, 1995, 61(8): 718-720.
6.	Bergemann JL, Hibbert ML, Harkins G,et al. Omental herniation through a 3-mm umbilical trocar site: unmasking a hidden umbilical hernia. J Laparoendosc Adv Surg Tech, 2001, 11(3): 171-173.
7.	姚庆东, 程小杰, 张呈兵, 等. 腹壁切口疝多层螺旋CT术前诊断价值. 实用放射学杂志, 2015, 31(8): 1294-1300.
8.	中华医学会外科学分会疝和腹壁外科学组与中国医师协会外科医师分会疝和腹壁外科医师委员会. 腹壁切口疝诊疗指南(2014年版). 中华外科杂志, 2014, 52(7): 485-488.
9.	李三党, 景化忠, 韩晓鹏, 等. 腹腔镜下修补老年患者腹壁切口疝24例体会. 中国现代普通外科进展, 2014, 17(8): 637-639.
10.	方钱, 王卫军, 李剑锋, 等. 腹腔镜下腹壁切口疝修补56例临床分析. 浙江医学, 2015, 37(6): 505-507.
11.	于游, 王灿, 吴强, 等. 腹壁切口疝的外科治疗(附78例临床分析) . 中国普外基础与临床杂志, 2009, 16(6): 475-477.
12.	顾岩. 内镜组织结构分离技术治疗腹壁缺损. 中华普外科手术学杂志: 中华普外科手术学杂志(电子版), 2014, 8(3): 15-18.
13.	费阳, 李基业. 腹腔镜下修补70岁以上患者腹壁切口疝(附8例报道). 中国普外基础与临床杂志, 2010, 17(3): 263-266.
14.	耿兴隆, 秦伟, 戴勇, 等. 切口疝腹腔镜与开放修补术的疗效及安全性的Meta分析. 中山大学学报: 中山大学学报(医学科学版), 2014, 35(4): 633-635.
15.	章小兵, 江四平, 毛水清, 等. 腹壁切口疝合成补片修补感染的危险因素分析与预防对策.现代实用医学, 2015, 17(4): 480-481.
16.	Waldhaussen JH. Incisional hernia in a 5-mm trocar site following pediatric laparoscopy. J Laparoendosc Surg, 1996, 6(1): 89-90.
17.	Romagnolo C, Minelli L. Small-bowel occlusion after operative laparoscopy: our experience and review of the literature. Endoscopy, 2001, 33(1): 88-90.
18.	Korenkov M, Rixen D, Paul A,et al. Combined abdominal wall paresis and incisional hernia after laparoscopic cholecystectomy. Surg Endosc, 1999, 13(3): 268-269.
19.	彭永海, 杨倩, 李洪永, 等. 腹腔镜术后切口疝的原因及防治对策. 腹腔镜外科杂志, 2010, 15(11): 841-843.
20.	Geraci G, Sciume C, Pisello F,et al. Trocar-related abdominal wall bleeding in 200 patients after laparoscopic cholecistectomy: Personal experience. World J Gastroenterol, 2006, 12(44): 7165-7167.
21.	胡三元. 腹腔镜胆囊切除术严重并发症的预防及处理. 腹部外科, 2014, 27(3): 153-156.
22.	鱼国盛, 汤黎明, 朱剑飞, 等. 腹腔镜手术穿刺相关出血的原因分析与对策. 中国普外基础与临床杂志, 2011, 18(11): 1214-1215.
23.	董小刚, 王伟林, 王杰. 腹腔镜穿刺孔大出血的预防和处理(附五例报告). 腹部外科, 2015, 28(1): 47-49.
24.	许景洪, 李立志, 王文文, 等. 腹部腹腔镜手术后大块标本取出切口并发症的多因素分析. 中国微创外科杂志, 2014, 14(9): 792-795.
25.	黄飞, 卢榜裕, 蔡小勇, 等. 腹腔镜肝切除术的常见并发症及其防治. 腹部外科, 2014, 27(3): 172-175.
26.	虞立平, 段建春 , 戴国芳, 等. 腹腔镜穿刺孔缝合方法改进. 中华肝胆外科杂志, 2014, 20(10): 726-727.

1. Azevedo JI, Azevedo OC, Miyahira SA,et al. Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review. Surg Endosc, 2009, 23(7): 1428-1432.
2. Fear RE. Laparoscopy: a valuable aid in gynecologic diagnosis. Obstet Gynecol, 1968, 31(3): 297-309.
3. Montz FJ, Holschneider CH, Munro MG. Incisional hernia following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists. Obstet Gynecol, 1994, 84(5): 881-884.
4. Nassar AH, Ashkar KA, Rashed AA,et al. Laparoscopic cholecystectomy and the umbilicus. Br J Surg, 1997, 84(5): 630-633.
5. Azurin DJ, Go LS, Arroyo LR,et al. Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. Am Surg, 1995, 61(8): 718-720.
6. Bergemann JL, Hibbert ML, Harkins G,et al. Omental herniation through a 3-mm umbilical trocar site: unmasking a hidden umbilical hernia. J Laparoendosc Adv Surg Tech, 2001, 11(3): 171-173.
7. 姚庆东, 程小杰, 张呈兵, 等. 腹壁切口疝多层螺旋CT术前诊断价值. 实用放射学杂志, 2015, 31(8): 1294-1300.
8. 中华医学会外科学分会疝和腹壁外科学组与中国医师协会外科医师分会疝和腹壁外科医师委员会. 腹壁切口疝诊疗指南(2014年版). 中华外科杂志, 2014, 52(7): 485-488.
9. 李三党, 景化忠, 韩晓鹏, 等. 腹腔镜下修补老年患者腹壁切口疝24例体会. 中国现代普通外科进展, 2014, 17(8): 637-639.
10. 方钱, 王卫军, 李剑锋, 等. 腹腔镜下腹壁切口疝修补56例临床分析. 浙江医学, 2015, 37(6): 505-507.
11. 于游, 王灿, 吴强, 等. 腹壁切口疝的外科治疗(附78例临床分析) . 中国普外基础与临床杂志, 2009, 16(6): 475-477.
12. 顾岩. 内镜组织结构分离技术治疗腹壁缺损. 中华普外科手术学杂志: 中华普外科手术学杂志(电子版), 2014, 8(3): 15-18.
13. 费阳, 李基业. 腹腔镜下修补70岁以上患者腹壁切口疝(附8例报道). 中国普外基础与临床杂志, 2010, 17(3): 263-266.
14. 耿兴隆, 秦伟, 戴勇, 等. 切口疝腹腔镜与开放修补术的疗效及安全性的Meta分析. 中山大学学报: 中山大学学报(医学科学版), 2014, 35(4): 633-635.
15. 章小兵, 江四平, 毛水清, 等. 腹壁切口疝合成补片修补感染的危险因素分析与预防对策.现代实用医学, 2015, 17(4): 480-481.
16. Waldhaussen JH. Incisional hernia in a 5-mm trocar site following pediatric laparoscopy. J Laparoendosc Surg, 1996, 6(1): 89-90.
17. Romagnolo C, Minelli L. Small-bowel occlusion after operative laparoscopy: our experience and review of the literature. Endoscopy, 2001, 33(1): 88-90.
18. Korenkov M, Rixen D, Paul A,et al. Combined abdominal wall paresis and incisional hernia after laparoscopic cholecystectomy. Surg Endosc, 1999, 13(3): 268-269.
19. 彭永海, 杨倩, 李洪永, 等. 腹腔镜术后切口疝的原因及防治对策. 腹腔镜外科杂志, 2010, 15(11): 841-843.
20. Geraci G, Sciume C, Pisello F,et al. Trocar-related abdominal wall bleeding in 200 patients after laparoscopic cholecistectomy: Personal experience. World J Gastroenterol, 2006, 12(44): 7165-7167.
21. 胡三元. 腹腔镜胆囊切除术严重并发症的预防及处理. 腹部外科, 2014, 27(3): 153-156.
22. 鱼国盛, 汤黎明, 朱剑飞, 等. 腹腔镜手术穿刺相关出血的原因分析与对策. 中国普外基础与临床杂志, 2011, 18(11): 1214-1215.
23. 董小刚, 王伟林, 王杰. 腹腔镜穿刺孔大出血的预防和处理(附五例报告). 腹部外科, 2015, 28(1): 47-49.
24. 许景洪, 李立志, 王文文, 等. 腹部腹腔镜手术后大块标本取出切口并发症的多因素分析. 中国微创外科杂志, 2014, 14(9): 792-795.
25. 黄飞, 卢榜裕, 蔡小勇, 等. 腹腔镜肝切除术的常见并发症及其防治. 腹部外科, 2014, 27(3): 172-175.
26. 虞立平, 段建春 , 戴国芳, 等. 腹腔镜穿刺孔缝合方法改进. 中华肝胆外科杂志, 2014, 20(10): 726-727.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Study on the clinical value of sewing up incision by elastic snell needle in laparoscopic operation

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content