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：

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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.	姚慶東, 程小杰, 張呈兵, 等. 腹壁切口疝多層螺旋CT術前診斷價值. 實用放射學雜志, 2015, 31(8): 1294-1300.
8.	中華醫學會外科學分會疝和腹壁外科學組與中國醫師協會外科醫師分會疝和腹壁外科醫師委員會. 腹壁切口疝診療指南(2014年版). 中華外科雜志, 2014, 52(7): 485-488.
9.	李三黨, 景化忠, 韓曉鵬, 等. 腹腔鏡下修補老年患者腹壁切口疝24例體會. 中國現代普通外科進展, 2014, 17(8): 637-639.
10.	方錢, 王衛軍, 李劍鋒, 等. 腹腔鏡下腹壁切口疝修補56例臨床分析. 浙江醫學, 2015, 37(6): 505-507.
11.	于游, 王燦, 吳強, 等. 腹壁切口疝的外科治療(附78例臨床分析) . 中國普外基礎與臨床雜志, 2009, 16(6): 475-477.
12.	顧巖. 內鏡組織結構分離技術治療腹壁缺損. 中華普外科手術學雜志: 中華普外科手術學雜志(電子版), 2014, 8(3): 15-18.
13.	費陽, 李基業. 腹腔鏡下修補70歲以上患者腹壁切口疝(附8例報道). 中國普外基礎與臨床雜志, 2010, 17(3): 263-266.
14.	耿興隆, 秦偉, 戴勇, 等. 切口疝腹腔鏡與開放修補術的療效及安全性的Meta分析. 中山大學學報: 中山大學學報(醫學科學版), 2014, 35(4): 633-635.
15.	章小兵, 江四平, 毛水清, 等. 腹壁切口疝合成補片修補感染的危險因素分析與預防對策.現代實用醫學, 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, 楊倩, 李洪永, 等. 腹腔鏡術后切口疝的原因及防治對策. 腹腔鏡外科雜志, 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. 腹腔鏡膽囊切除術嚴重并發癥的預防及處理. 腹部外科, 2014, 27(3): 153-156.
22.	魚國盛, 湯黎明, 朱劍飛, 等. 腹腔鏡手術穿刺相關出血的原因分析與對策. 中國普外基礎與臨床雜志, 2011, 18(11): 1214-1215.
23.	董小剛, 王偉林, 王杰. 腹腔鏡穿刺孔大出血的預防和處理(附五例報告). 腹部外科, 2015, 28(1): 47-49.
24.	許景洪, 李立志, 王文文, 等. 腹部腹腔鏡手術后大塊標本取出切口并發癥的多因素分析. 中國微創外科雜志, 2014, 14(9): 792-795.
25.	黃飛, 盧榜裕, 蔡小勇, 等. 腹腔鏡肝切除術的常見并發癥及其防治. 腹部外科, 2014, 27(3): 172-175.
26.	虞立平, 段建春 , 戴國芳, 等. 腹腔鏡穿刺孔縫合方法改進. 中華肝膽外科雜志, 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. 姚慶東, 程小杰, 張呈兵, 等. 腹壁切口疝多層螺旋CT術前診斷價值. 實用放射學雜志, 2015, 31(8): 1294-1300.
8. 中華醫學會外科學分會疝和腹壁外科學組與中國醫師協會外科醫師分會疝和腹壁外科醫師委員會. 腹壁切口疝診療指南(2014年版). 中華外科雜志, 2014, 52(7): 485-488.
9. 李三黨, 景化忠, 韓曉鵬, 等. 腹腔鏡下修補老年患者腹壁切口疝24例體會. 中國現代普通外科進展, 2014, 17(8): 637-639.
10. 方錢, 王衛軍, 李劍鋒, 等. 腹腔鏡下腹壁切口疝修補56例臨床分析. 浙江醫學, 2015, 37(6): 505-507.
11. 于游, 王燦, 吳強, 等. 腹壁切口疝的外科治療(附78例臨床分析) . 中國普外基礎與臨床雜志, 2009, 16(6): 475-477.
12. 顧巖. 內鏡組織結構分離技術治療腹壁缺損. 中華普外科手術學雜志: 中華普外科手術學雜志(電子版), 2014, 8(3): 15-18.
13. 費陽, 李基業. 腹腔鏡下修補70歲以上患者腹壁切口疝(附8例報道). 中國普外基礎與臨床雜志, 2010, 17(3): 263-266.
14. 耿興隆, 秦偉, 戴勇, 等. 切口疝腹腔鏡與開放修補術的療效及安全性的Meta分析. 中山大學學報: 中山大學學報(醫學科學版), 2014, 35(4): 633-635.
15. 章小兵, 江四平, 毛水清, 等. 腹壁切口疝合成補片修補感染的危險因素分析與預防對策.現代實用醫學, 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, 楊倩, 李洪永, 等. 腹腔鏡術后切口疝的原因及防治對策. 腹腔鏡外科雜志, 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. 腹腔鏡膽囊切除術嚴重并發癥的預防及處理. 腹部外科, 2014, 27(3): 153-156.
22. 魚國盛, 湯黎明, 朱劍飛, 等. 腹腔鏡手術穿刺相關出血的原因分析與對策. 中國普外基礎與臨床雜志, 2011, 18(11): 1214-1215.
23. 董小剛, 王偉林, 王杰. 腹腔鏡穿刺孔大出血的預防和處理(附五例報告). 腹部外科, 2015, 28(1): 47-49.
24. 許景洪, 李立志, 王文文, 等. 腹部腹腔鏡手術后大塊標本取出切口并發癥的多因素分析. 中國微創外科雜志, 2014, 14(9): 792-795.
25. 黃飛, 盧榜裕, 蔡小勇, 等. 腹腔鏡肝切除術的常見并發癥及其防治. 腹部外科, 2014, 27(3): 172-175.
26. 虞立平, 段建春 , 戴國芳, 等. 腹腔鏡穿刺孔縫合方法改進. 中華肝膽外科雜志, 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

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