探讨腹腔镜治疗小儿隐睾合并同侧腹股沟斜疝术中关闭内环口是否必要。

收集2009年6月至2016年5月间宜昌市第二人民医院50例隐睾合并同侧腹股沟斜疝行腹腔镜睾丸下降固定术的患儿临床资料。腹腔镜下彻底游离精索后所有的睾丸均经腹股沟管下降至阴囊，内环口均未缝合关闭。观察手术时间、睾丸下降情况及并发症等。

50例患儿鞘状突均未闭合，其中腹股沟管型隐睾39例，腹腔型隐睾11例。平均手术时间72 min，所有患儿睾丸均一期下降固定于阴囊。所有病例随访时间9个月至6.5年，中位时间3年，睾丸回缩至阴囊上方3例，超声复查无一例患儿腹股沟斜疝复发。

隐睾合并同侧腹股沟斜疝行腹腔镜睾丸下降固定术安全、有效，术中缝合关闭内环口也许是不必要的。

To explore the necessary of closure of the internal ring for cryptorchidism complicated with ipsilateral indirect inguinal hernia.

Clinical data of 50 children with cryptorchidism complicated with ipsilateral indirect henia from June 2009 to May 2016 were analyzed in this study. All the cases underwent laparoscopic orchiopexy. All testes after complete mobilization were pulled down into the scrotum through the inguinal canal. No suture was applied to close the internal ring. The operative duration, profile of testicular descending and complication were assessed.

Patent processus vaginalis was found in all 50 cases. There were 39 cases with inguinal canal cryptorchidism, 11 cases with intra-abdominal cryptorchidism. The mean operative time was 72 minutes. Primary orchidopexy was performed in all cases. The median follow up of all cases was 3 years (9 months to 6.5 years). There were 3 cases of testicular retraction to the top of the scrotum. No case was found recurrence of a hernia in ultrasound examination.

Laparoscopic orchidopexy is a safe and effective approach for children with cryptorchidism complicated with ispilateral indirect hernia. The closure of internal ring may not be necessary.