免气囊分离器完全腹膜外补片腹腔镜腹股沟疝修补术

Laparoscopic total extraperitoneal inguinal herniorrhaphy using no balloon dissector

目的探讨免气囊分离器完全腹膜外补片腹腔镜腹股沟疝修补术的可行性.方法2003年11月～2004年4月完成10例,其中腹股沟斜疝7例,隐匿性斜疝合并直疝1例,直疝2例,其中1例为复发性直疝.结果10例均获成功,平均手术时间69.5 min,平均出血量11ml,平均术后住院时间2.1 d,平均恢复日常活动时间5.2 d.腹壁下动脉游离、误入解剖层次和腹膜撕裂各1例.随访时间1～6个月,未见复发及神经性疼痛等并发症.结论免气囊分离器完全腹膜外补片腹腔镜腹股沟疝修补术可行,安全,有效.

Objective To explore the feasibility of laparoscopic total extraperitoneal hernia repair without the use of the balloon dissector. Methods Laparoscopic total extraperitoneal hernia repair using no balloon dissector was completed in 10 cases of groin hernia from November 2003 to April 2004, including 7 cases of indirect inguinal hernia, 1 case of occult indirect hernia combined with direct inguinal hernia, and 3 cases of clirect inguinal hernia （ 1 of which was recurrent hernia）. Results All the 10 operations were successful. The mean operation time was 69.5 min, the mean blood loss was 11 ml, the mean postoperative hospital stay was 2. 1 days, and the mean duration to normal activities, 5.2 days. Complications included 1 case of disassociated inferior epigastric artery, 1 case of operation in wrong anatomic layer, and 1 case of laceration of the peritoneum, respectively. Follow-up observations for 1-6 months found no recurrence and neuropathic pain. Conclusions Laparoscopic total extraperitoneal hernia repair without the use of the balloon dissector is feasible, safe and effective.