介绍腹腔镜腹股沟直疝修补术中应用锁扣夹高位结扎闭合假疝囊的方法，并对其效果进行观察评估。

49例（60侧）腹股沟直疝患者接受腹腔镜经腹腹膜前（TAPP）手术。在补片放置前，用分离钳夹住假疝囊底部并向外拖出，顺时针旋转分离钳转向旋钮，使假疝囊螺旋状拧紧如麻花状，再以大号或加大号锁扣夹高位结扎假疝囊，闭合假疝囊缺损。术中观察假疝囊闭合操作时间，术后观察血清肿发生、局部异物感、第1、3天疼痛程度、住院时间及术后其他并发症。

手术平均时间（45±14）min。术中无精索、血管、神经、内脏损伤。假疝囊锁扣夹夹闭1次即达到满意效果的46侧，需2次夹闭的14侧。单次夹闭时间0.6~2 min，平均1.0 min。50侧假疝囊闭合满意（闭合后缺损消失），10侧基本满意（闭合后轻度凹陷0.2~0.4 cm）。术后3 d见2例轻度血清肿，未做处理。术后第1、3天疼痛轻不需应用止痛剂。术后腹股沟区异物感不明显。住院时间1~7 d，平均2.3 d。术后1、3、6个月随访未见复发、感染、疼痛、睾丸萎缩等并发症。

锁扣夹高位结扎闭合直疝假疝囊是一种简单、有效、安全的方法。

To introduce a method of high ligation of pseudo-sac using hemo-o-lock in laparoscopic direct inguinal hernia repair, and to observe and evaluate its effect.

49 patients (60 sides) with direct inguinal hernia underwent laparoscopic trans-abdominal preperitoneal hernia repair (TAPP). Before placing the mesh, a clamp was used to pull out of the bottom of the pseudo-sac. Twist the clamp clockwise to make the sac to fried dough twist shape, then a large or extra-large hemo-o-lock was ligated on the base of the twister to close the defect. The closing time of pseudo-sac, the occurrence of postoperative seroma, local foreign body sensation, postoperative pain on the first and third days, hospital stays, and other postoperative complications were observed.

The average operation time was (45±14) min. There was no spermatic cord, blood vessel, nerve or viscera injury. A total of 60 sides of pseudo-sac in 49 cases were closed using hemo-o-lock. 46 sides achieved satisfactory results with one closure, 14 sides needed a second closure. The single operation time was 0.6-2 min, with an average of 1.0 min. The closure of the pseudo-sac was satisfactory on 50 sides (the defect disappeared after closure), and basically satisfactory on 10 sides (slight depressed 0.2-0.4 cm after closure). 3 days after operation, 2 cases had mild seroma, which was not treated. No analgesic was needed for mild pain on the first and third days after surgery. There is no obvious postoperative foreign body sensation in the groin area. The duration of hospitalization ranged from 1 to 7 days, with an average of 2.3 days. No recurrence, infection, pain or testicular atrophy were found during the follow-up at 1, 3 and 6 months postoperatively.

It is a simple, effective, and safe method to close the pseudo-sac of direct hernia by high ligation using a hemo-o-lock.