改良式腹腔镜腹膜外补片植入法疝修补术

Modified laparoscopic transabdomimal preperitoneal mesh and suture herniorrhaphy

目的探讨改进式腹腔镜腹膜外补片植入法腹股沟疝修补术的可行性及临床意义.方法回顾性分析我院2002年6月～2004年10月13例腹股沟疝进行的腹腔镜下经腹腔腹膜外补片植入法联合腹膜缝合覆盖修补术的临床资料.其中腹股沟斜疝9例,直疝4例;其中复发疝1例;右侧8例,左侧4例,双侧1例.结果手术均获成功,单侧手术时间35～85 min,平均50 min,无一例中转开腹,无术后并发症,术后平均住院时间2 d,13例随访1～28个月,平均12个月,无一例复发.结论腹腔镜下经腹腔途径腹膜外补片植入法联合腹膜缝合覆盖术是一种安全、可靠、疗效显著的腹股沟疝修补方法,具有手术操作简单、创伤小、术后疼痛轻、恢复快等优点,可以代替开放手术,值得推广应用.

Objective To investigate the teasibility and the clinical significance of moditied laparoscopic transabdomimal preperitoneal （TAPP） mesh and suture inguinal herniorrhaphy. Methods Clinical records of 13 patients with inguinal hernia treated by laparoscopic TAPP mesh plug combined with suture fixation from June 2002 to October 2004 in this hospital were retrospectively reviewed. Out of the 13 patients, there were 9 patients with indirect inguinal hernia and 4 patients with direct hernia, including 1 recurrent patient. The hernia was right - sided in 8 patients, left - sided in 4, and bilateral in 1. Results All the operations were completed successfully. The unilateral operation time was 35 -85 min （mean, 50 min）. No conversions to open surgery were required and no postoperative complications were noted. The mean duration of postoperative hospital stay was 2 days. Follow-up observations for 1-28 months （mean, 12 months） in the 13 patients found no recurrence. Conclusions Laparoscopic TAPP mesh plug combined with suture fixation, characterized by advantages of simplicity of performance, minimal invasion, little postoperative pain, and quick recovery, is a safe, reliable and effective alternative of inguinal herniorrhaphy. This technique can replace the open surgery and is recommended for wide application.