肥胖患者腹壁巨大切口疝腹腔镜手术配合中精准化管理与应用

Accurate management and application of laparoscopy coordination in giant incisional hernia of abdominal wall in obese patients

目的总结分析肥胖患者腹壁巨大切口疝腹腔镜手术的手术配合要点及相应的管理措施,观察其应用效果。方法回顾分析2019年7月至2021年6月,在首都医科大学附属北京朝阳医院接受腹腔镜下切口疝修补术的84例肥胖患者的临床资料,对患者手术结果以及术中配合体会进行总结,分析其应用效果。结果84例患者腹腔镜下切口疝修补术均获成功,效果满意,未出现由于肥胖而导致的皮肤压力性损伤,手术器械设备使用不当导致的灼伤,以及手术部位感染等并发症。结论采取有效的预防措施、科学的术前计划、术中管理、细致的管理措施,可以提高肥胖患者腹壁巨大切口疝腹腔镜手术的预期效果,预防并发症。

Objective to summarize and analyze the key points of operative cooperation and corresponding management measures for huge incisional hernias during of abdominal laparoscopy in obese patients,and to observe the application effect.Methods From July 2019 to June 2021,the clinical data of 84 obese patients who underwent laparoscopic incisional hernia repair in the Beijing Chao-Yang Hospital were reviewed,to sum up the results of the operation and the experience of cooperation during the operation,and analyze the effect of application.Results Laparoscopic incisional hernia repair was successful in all 84 patients and satisfactory in all patients,with no skin pressure injury due to obesity,and burns due to improper use of surgical instruments and equipment,and surgical site infection,or other complications.Conclusion Effective preventive measures,scientific preoperative planning,intraoperative management,and careful management can improve the expected outcome of huge abdominal incisional hernias in obese patients and prevent laparoscopy complications.