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:: Damsoyu hospital > Specialized Clinics > Pediatric Hydrocele ::

소아 음낭수종

담소유외과는 진정한 외과전문병원 리더가 되기 위해 가장 먼저 도전하고 노력합니다.

음낭수종의 치료는?

Treatment for hydrocele is surgery. Removing the fluid with syringe will result recurrence so the fluid sac needs to be surgically removed. The fluid-filled sac can be surgically removed from the scrotum, but at other hospitals, inguinal hernia is also resected because babies with Pediatric Hydrocele also have hernia opening. In other words, Pediatric Hydrocele is not a surgery that removes the fluid-filled sac but also covering the hernia opening.

음낭수종의 수술
이미지 - 타 병원 수술
Dam So Yu Hospital is the only hospital that performs pediatric hydrocele surgery using the with laparoscopic surgery method. Laparoscopic pediatric hydrocele surgery leaves micro surgical scar.
이미지 - 복강경 음낭수종수술 흉터
Since the cause of pediatric hydrocele is opening of hernia, we make sure to check the other side when we perform surgery to prevent recurrence.
이미지 - 타 병원 수술 후 반대쪽 재발(왼쪽 개복수술의 흉터, 오른쪽 음낭수종의 재발, 복강경 수술후의 흉터(타 병원 수술의 흉터만 보이고 복강경수술의 흉터는 안보인다)), 제거된 음낭수종
Communicating hydrocele is a disease that fluid goes back and forth through the hernia opening and fluid sac does not exist. Surgically covering up the hernia opening can be done for the treatment.
이미지 - 교통성 음낭수종 복강경수술
Non-communicating Hydrocele is a caused by excessive fluid production and is a condition present at birth but usually resolves spontaneously. However, non-communicating hydrocele needs be surgically treated for child age 2 or older, or if the size of fluid sac is too large that it pressures the scrotum.
이미지 - 초막내 음낭수종 복강경수술
Separated fluid sac from scrotum exists and unlike non-communicating, Hydrocele this disease has higher chance of not resolving on its own after the age of two. With the diagnostic sonography, it may be diagnosed as funicular hydrocele but when the actual surgery is performed, many cases turn out to be communicating hydrocele. When conducting the surgery, fluid sac needs to be completely removed and opening of hernia needs to be closed.
이미지 - 정삭의 음낭수종 복강경수술
Before pulling the fluid-filled sac, hernia opening is located. Fluid sac is located next to the hernia opening.
이미지 - 복강경 정삭의 음낭수종수술
The cause of recurrence after undergoing surgery at other hospital is when the fluid sac hasn’t been completely removed.
이미지 - 타 병원 수술 후 양쪽 재발
Surgical scar after undergoing surgery at other hospital / Both sides re-operated at Dam So Yu, after undergoing laparoscopic surgery at other hospital. Scar that has been left from the previous laparoscopic surgery can only be seen.
이미지 - 복강경 정삭의 음낭수종수술(탈장구멍 - 음낭수종을 제거함 - 수종이 제거됨 - 탕장구멍 봉합 - 제거된 오른쪽 음낭수종)
Images above show the steps of removing hydrocele which was located on the right side. First, opening of hernia is located and hydrocele is removed. Finally, the opening of hernia is sutured.
이미지 - 타 병원 수술 후 양쪽 재발(탈장구멍 - 음낭수종을 제거함 - 수종이 제거됨 - 탈장구멍 봉합 - 제거된 오른쪽 음낭수종)
Same procedure is done on the left side.

국내 최다 수술 집도 담소유외과 복강경 수술

Pediatric surgery is hard to perform when operating room is not equipped with the right instruments. However, the most important factor is the doctor’s clinical experience and surgery skills. At Dam So Yu Hospital, we have two pediatric anesthesia specialists, taking charge of anesthesia.

Total 5936 Cases of Laparoscopic Performed at Dam So Yu Hospital
담소유외과 복강경 수술 총 5936례
Number of Patients(%) Weight(Kg) Surgical Duration(min) Both Incarcerated
Total 5936 3628(61%) 233(4%)
0~3months 1066 5.14 15.9 857 110
3~12months 576 9.27 15.3 338 32
1~2years 895 11.2 14.5 593 8
2~5years 1569 15.2 13.0 1021 7
5~10years 782 22.1 12.1 461 5
10~18years 969 29.6 322 69

소아 전문마취의가 상주, 수면/전신 마취

  • 사진-마취과 전문의 송 은 과장 / 진료과목:마취과 / 학력:부산대학교 의과대학 졸업 / 경력:서울대병원 마취통증의학과 전공의, 서울대병원 마취통증의학과 전문의, 서울아산병원 마취통증의학과 전임의 / 학회활동:대한소아마취학회 정회원, 대한마취과학회 정회원, 대한통증학회 정회원, 대한통증학회 TPI과정 이수
  • 사진-마취과 전문의 장연희 과장 / 진료과목:마취과 / 학력:연세대학교 의과대학 졸업 / 경력:세브란스병원 마취통증의학과 전공의, 세브란스병원 마취통증의학과 전문의 / 학회활동: 대한마취과학회 정회원, 대한통증학회 정회원, 대한척추통증학회 정회원, 대한통증연구학회 정회원, 대한통증학회 TPI과정 이수
  • Dam So Yu Hospital specializes in surgical operations not cosmetic surgeries.
  • Dam So Yu Hospital specializes in surgical operation to a wide range of patients from newborn babies to adolescent under 18 years old. Inguinal hernia and other surgeries are conducted using laparoscopic surgical method.
  • When it comes to pediatric surgeries, it is important that surgeries are completely asepsis.
    This is why we use disposable sterilization wrap.
  • When conducting clean surgery, antibiotics are not injected. It’s because surgery is carried out completely asepsis. We do not inject antibiotics before carrying out surgery and no inflammation is caused.

소아전용 수술기구 완비

When it comes to pediatric hernia laparoscopic surgery, the laparoscopic system is very important.

담소유외과 소아탈장수술 복강경시스템
이미지 - stryker 1288 hd 2.9mm camera 장비
Dam So Yu Hospital is equipped with 1288 HD system from Stryker’s.
3 years ago, we had 1188 HD system, but now we use 1288 HD system for high-resolution display.
For pediatric surgeries, using medical instruments for adult can be very dangerous. We use 2.7mm medical instrument for children.
소아탈장 복강경 기구
이미지 - 2.7mm karl-storz instrument/2.9mm camera, 2.7mm instrument 장비
For patients’ health and safety, we have two experienced anesthesiologists, with wide clinical experience.
For anesthesia equipment, we use German based company Dräger.
All three general anesthesia operating rooms are equipped with Dräger’s FABLUS PLUS.
담소유외과 마취기구(DRAGER FABIUS PLUS)
이미지 - 마취기구
Some hospital put patients under sedation despite the fact that these hospitals are not equipped with or don’t possess general anesthesia equipment. Ideally, for safety reasons, hospitals need to be equipped with general anesthesia equipment even when putting patients under sedation.
Our hospital has three aseptic operating rooms, equipped for general anesthesia.
가온가습 마취회로(Warming and humidifying tube)
By Installing special electronic device and humidifier inside the manifold of the breathing duct, it maintains constant temperature and humidity of the anesthetic has that’s being provided to patient going under anesthesia. This tube helps prevent postoperative pulmonary complications.
사진-가온가습 마취회로
마취 중 각성상태 측정(BIS)
Bispectral index is used to monitor, and observe the depth of anesthesia, and the patients’ vigilance can be controlled while putting patient under anesthesia. However, it is not widely used yet since it is not covered by health insurance.
사진-마취 중 각성상태 측정
피부접착제(SurgiSeal>
Seals the opening where the laparoscopic instrument was inserted with medical adhesive for skin. Therefore, patients can shower on the same day of surgery.
이미지 - 피부 접착제
유착방지제(Protad)
We apply Protad on the suture area in case of intestine adhesion
사진-유착방지제 도포 전/후

왜! 소아탈장, 음낭수종, 맘모톰, 복강경수술은 담소유외과에서 해야할까?

이미지 - 수술장면

수술에서 가장 중요한 점은 환자의 불편함을 없애는 목적이 최우선이어야 합니다.

수술 이후에 재발이 되면 안됩니다.

반드시 정확하고 안전한 수술로 치료해야 합니다. 그 다음으로 흉터가 중요합니다. 적게 상처를 내서 완전한 수술이 가능하면 최상입니다. 저희 병원에서 시행하는 소아탈장 복강경수술은 흉터가 안보이게 됩니다.

음낭수종이란?

A hydrocele testis is the accumulation of fluids around a testicle. Mainly, it is divided into two, which are communicating hydrocele and blocked non-communicating hydrocele. It is a state of the pit pair of tunica vaginalis, the wall between viscera and intestinal juice. The size of the hydrocele is various, and can be divided into three.

소아 음낭수종의 종류
이미지 - 고환 초막내 음낭수종, 정삭의 음낭수종, 교통성 음낭수종
Non-communicating hydrocele is divided into hydrocele testis and hydrocele of Vas Deferens. From the testis, hydrocele can be classified by where the fluid sac is formed and whether the fluid inside is either stagnant or flows through the stomach. Hydrocele testis is a type of hydrocele when layer surrounding the testicle gets filled with fluid. This is known to resolve on its own. However, if the hydrocele persists or if the size of fluid sac is too large, it can cause severe pressure on the scrotum so surgical repair will be necessary. Communicating hydrocele occurs when testis has been descended but the hydrocele within tunica vaginalis does not entirely get blocked. It is commonly diagnosed among children. The size of fluid sac can differ depending on the child’s posture and activities. If the hole is large, it can accompany hernia. Full-term delivery accounts about 6%.
음낭수종의 증상은?
Pediatric hydrocele have symptom of testicle and inguinal region bulging. Depending on the type of hydrocele, symptoms are different. The signs of non-communicating hydrocele: the size of scrotum itself looks large, the color turns into dark blue, and because the testicle is placed inside the fluid-sac it looks like the whole testicle has been enlarged.
이미지 - 고환 초막내 음낭수종(고환전체가 커지며 검푸른색깔)1
이미지 - 고환 초막내 음낭수종(고환전체가 커지며 서혜부까지 약간 불룩해지기도 함)2
On the other hand, hydrocele of vas deferens has fluid-filled sac that is separated from the testis. Visually, it seems like child has another testicle. Most parents describe the symptom as having three testicles.
이미지 - 정삭의 음낭수종(고환이 하나 더 생긴 것 처럼 보임)
이미지 - 고환과 분리된 물주머니가 보임
The easy way to determine the type of hydrocele is to see if it looks like another testis has been formed. If it does look like another testis has been formed, then there is a high chance of hydrocele of vas deferens (정삭의음낭수종)
이미지 - 담소유외과 소아 음낭수종(고환초막내 음낭수종, 정삭의 음낭수종)
Communicating hydrocele has no separate fluid sac and through the hernia opening, the fluid goes back and forth through the space in the stomach and between the scrotums. It is diagnosed as inguinal hernia when a loop of intestine, fat, or tissue slips out of place inside your abdomen. If fluid flows around, it is diagnosed as communicating hydrocele.
이미지 - 교통성 음낭수종(교통성 음낭수종으로 물이 고환으로 내려옴, 물이 다시 배안으로 들어가서 고환은 정상이됨)

음낭수종의 진단은?

When diagnosing hydrocele, visual observation is conducted along with clinical signs check. Then with ultrasonography, diagnosis is confirmed. When there is no fluid around the testicle, it is diagnosed as normal. In the ultrasound imaging, the water appears black and the testicles appear as round-shaped forms.

정상고환의 초음파
이미지 - 정상고환 양쪽
Hydrocele within the tunica vaginalis shows shape of testicle inside the fluid sac.
이미지 - 정삭의 음낭수종 (수종이 고환과 분리됨)
These two types of edema can be differentiated, exteriorly. However, to make sure, it is examined again with the diagnostic sonography. The main difference of two edema types in ultrasound is whether the fluid sac and testicle are separated or not.
이미지 - 음낭수종 비교(고환주위에 물이차 있음 - 고환초막내 음낭수종), 물주머니가 고환과 분리됨(정삭의 음낭수종)
The reason why differential diagnosis of the two edemas is so important is because the treatment method is different. Commonly, hydrocele is treated before and after the age of 2 by undergoing surgery. However, most of hydrocele resolves spontaneously, and hydrocele of vas deferens has higher chance of having continuous symptoms. Also, laparoscopic surgery can be performed for hydrocele of vas deferens. However, for hydrocele testis, about 1 cm resection below the testicle is performed to remove the sac. The size and shape of communicating hydrocele often fluctuates, and the size can be different depending on the posture or medical history of patients. Finally, diagnose is confirmed while conducting laparoscopic surgery, by pressing the testicle to see if the fluid moves up to the abdomen. Determining non-communicating and communicating is often difficult with sonography.
이미지 - 교통성 음낭수종(실제 수술소견은 탈장구멍으로 물이 이동하는 교통성 음낭수종)
hydrocele of vas deferens and inguinal hernia is hard to distinguish exteriorly.
이미지 - 음낭수종과 탈장의 외관 감별
If Separated testicle and sac is on the inguinal area, symptoms are identical to hernia. So it needs to be properly examined on ultrasonography.
이미지 - 음낭수종과 탈장의 감별(대망탈장, 창자탈장, 정삭의 음낭수종)

이성렬 원장 소아 복강경수술 국제학회발표 2013년 ~ 2014년

2014-11-27 66th Congress of the Korean Surgical Society
(Annual Congress of KSS 2014, 66th)
Location : COEX, Seoul, Korea
Laparoscopic operation of cryptorchidism
2014-11-27 66th Congress of the Korean Surgical Society
(Annual Congress of KSS 2014, 66th)
Location : COEX, Seoul, Korea
Laparoscopic Pediatric Inguinal Herniorrhaphy

2014-04-25 The 34th Annual Meeting of the KSLES &
2014 International Symposium
(KSLES 2014, Severance Hospital, Seoul, Korea)
Laparoscopic surgery of cryptorchidism and scrotal hydrocele
2013-11-27 9th INTERNATIONAL CONGRESS OF
THE ASIA-PACIFIC HERNIA SOCIETY
(APHS 2013)
Location : AsiaWorla-Expo in Hong Kong
Laparoscopic Pediatric Inguinal Herniorrhaphy, recur?
2013-11-21 12th Endoscopic&Laparoscopic Surgeons of Asia
(ELSA 2013)
Location : Taipei International Convention Center(TICC)
Laparoscopic Pediatric Inguinal Herniorrhaphy, Why do recur?
2013-05-09 The 32th Annual Meeting of the Korean Society of Endoscopic
and Laparoscopic Surgeons&2013 International Symposium
Laparoscopic Pediatric Inguinal Herniorrhaphy

이성렬 원장 소아 복강경수술 국제학회발표 2011년 ~ 2012년

2012-12-13 11th Endoscopic&Laparoscopic Surgeons of Asia
(ELSA 2012)
Location : Marriott Hotel, Saudi Arabia Riyadh
Laparoscopic herniorrhaphy of pediatric inguinal hernia
2012-11-29 64th Annual Congress of the Korean Surgical Society
Location : COEX, Seoul, Korea
Laparoscopic hydrocelectomy of Pediatric Inguinal hernia patients
2012-06-01 7th international postgraduate course
of laparoscopic Surgery
Pediatric Inguinal Hernia

2012-03-31 The 30th Annual Meeting of the KSLES &
2012 International Symposium
(Laparoscopic pediatric inguinal hernia repair : ovary & fallopian tube incarceration)
2011-11-25 63th Annual Congress of the Korean Surgical Society
Location : COEX, Seoul, Korea
Laparoscopic herniorrhaphy of Pediatric Inguinal hernia patients

소아탈장복강경수술 최다집도의

사진-소아탈장 복강경 수술 최다기록 인증서/강남구 의료관광 협력기관 위촉장/NHN주식회사 의료상담 서비스 위촉장/네이버 소아탈장 검색 결과:소아탈장 복강경수술 1000례 돌파

2014-04-25 The 34th Annual Meeting of the KSLES  &   2014 International Symposium
(KSLES 2014, Severance Hospital,Seoul,Korea, 대한내시경복강경외과학회 국제심포지움) Laparoscopic surgery of cryptorchidism and scrotal hydrocele (소아 잠복고환과 음낭수종의 복강경수술) 주제발표
대한내시경 복강경외과학회 국제심포지움 관련 사진
2013-11-21 12th Endoscopic & Laparoscopic Surgeons of Asia
(ELSA 2013 , 아시아복강경외과학회 학술대회)    장소:Taipei International Convention Center(TICC), 대만 Laparoscopic Pediatric Inguinal Herniorrhaphy; Why do recur? (소아탈장의 복강경수술; 왜 재발하는가?)
아시아 복강경외과학회 학술대회 관련 사진
  • 12th Endoscopic & Laparoscopic Surgeons of Asia 사진 1
  • 12th Endoscopic & Laparoscopic Surgeons of Asia 사진 2
  • 12th Endoscopic & Laparoscopic Surgeons of Asia 사진 3
  • 12th Endoscopic & Laparoscopic Surgeons of Asia 사진 4
2013-11-27 9th INTERNATIONAL CONGRESS OF THE ASIA-PACIFIC HERNIA SOCIETY
(APHS 2013 , 아시아태평양탈장학회 학술대회)    장소: AsiaWorla-Expo in Hong Kong  (홍콩)  Laparoscopic Pediatric Inguinal Herniorrhaphy; recur? (소아탈장의 복강경수술; 재발의 원인은?)
  • 9th INTERNATIONAL CONGRESS OF THE ASIA-PACIFIC HERNIA SOCIETY 사진1
  • 9th INTERNATIONAL CONGRESS OF THE ASIA-PACIFIC HERNIA SOCIETY 사진2
  • 9th INTERNATIONAL CONGRESS OF THE ASIA-PACIFIC HERNIA SOCIETY 사진3
  • 사진-에딘버그대학병원 TULLO 교수
  • 사진-중국 탈장학회장 Jianxiong TANG
  • 사진-홍콩 탈장학회장 Peter YIP
2012-12-13 11th Endoscopic & Laparoscopic Surgeons of Asia
(ELSA 2012 , 아시아복강경외과학회 학술대회)  장소: 메리어트호텔, 사우디아라비아 리야드 Laparoscopic herniorrhaphy of pediatric inguinal hernia (소아탈장의 복강경수술)
  • 사진-11th Endoscopic & Laparoscopic Surgeons of Asia
  • 사진-에딘버그 대학병원 Gorgon 교수
2012-11-29 64th Annual Congress of the Korean Surgical Society
(제64회 대한외과학회 학술대회)   장소: 코엑스 서울 Laparoscopic hydrocelectomy of Pediatric Inguinal hernia patients( 소아탈장 환자에서 복강경 음낭수종 수술)
  • 64th Annual Congress of the Korean Surgical Society 사진1
  • 64th Annual Congress of the Korean Surgical Society 사진2
2013-05-09 The 32th Annual Meeting of the Korean Society of Endoscopic and Laparoscopic Surgeons&2013 International Symposium
Laparoscopic Pediatric Inguinal Herniorrhaphy (소아 서혜부탈장의 복강경탈장수술)
 The 32th Annual Meeting of the Korean Society of Endoscopic and Laparoscopic Surgeons&2013 International Symposium
2012-06-01 7th international postgraduate course of   laparoscopic Surgery
Pediatric Inguinal Hernia   (소아탈장의 복강경수술)
사진-7th international postgraduate course of   laparoscopic Surgery
2012-03-31 대한 내시경복강경외과학회 국제 학술대회
Laparoscopic pediatric inguinal hernia repair:  ovary & fallopian tube incarceration (복강경 수술에서 여아 서혜부탈장의 난소와 나팔관 감돈의 수술)
사진-2012 Intrnational Congress of the Korea Society of Endoscopic & Laparoscopic Surgeons
2011-11-25   63th Annual Congress of the Korean Surgical Society
(제63회 대한외과학회 학술대회)   장소: 코엑스 서울 Laparoscopic herniorrhaphy of Pediatric Inguinal hernia patients ( 소아탈장 환자에서 복강경 수술)
제 63회 대한외과학회 학술대회 관련 사진
학회발표 학회발표