腹腔镜腹股沟疝修补术(附56例报告)

Laparoscopic inguinal herniorrhapphy:a report of 56 cases

目的:探讨腹腔镜腹股沟疝修补术的优点、可行性及近期疗效。方法:2001年8月至2004年8月行腹腔镜经腹腔腹膜前补片修补术(transabdominalpreperitoneallaparoscopicmeshrepairofhernia,TAPP)和完全经腹膜外补片修补术(totallyextraperitoneallaparoscopicmeshrepairofhernia,TEP)共56例,其中腹股沟斜疝45例,腹股沟直疝8例,复合疝3例。结果:56例均成功完成手术,TAPP48例、56侧,TEP8例、9侧,术中发现对侧有隐性疝4例,复合疝3例。平均手术时间61.3±26.5min,术后平均住院4.3d。术后3例(5.4%)有残余疝囊积液。全部患者均获随访1～36个月,复发1例,复发率1.8%。结论:腹腔镜腹股沟疝修补术是安全可行的疝修补新方法,具有并发症少,术后患者疼痛轻,康复快、复发率低等优点,并可发现复合疝和隐性疝。

Objective: To investigate the effect and advantages of laparoscopic hernioplasty for inguinal hernia.Methods: From August 2001 to August 2004, 56 patients with inguinal hernia were treated with transabdominal preperitoneal laparoscopic mesh repair of hernia (TAPP) or totally extraperitoneal laparoscopic mesh repair of hernia (TEP). Of the 56 cases, 45 cases were indirect inguinal hernia, 8 cases were direct inguinal hernia and 3 cases were indirect and direct inguinal hernia.Results: All cases were operated successfully. TAPP was performed in 48 patients, TEP was performed in 8 cases. The mean operation time was 61.3±26.5(40180) minutes. The average postoperative stay was 4.3(27)days. The hydrops of remnant hernia cyst was found in 3 patients(5.4%) after operation. During followup of 136 months, 1 patient(1.8%) relapsed. Conclusions: Laparoscopic herniorrhapphy is safe and effective for inguinal hernia with advantages of low complication rate,quick recovery and low recurrence.