网塞式疝修补术的改进——网塞单针缝合固定法

Modified mesh-plug hernioplasty:a single suture for plug fixation

目的：探讨网塞式疝修补术中网塞固定技术的改进及其临床应用价值。方法：2003年4月～2004年12 月共对114例次斜疝和43例次直疝(包括8例次复发疝)实施了改良的网塞式疝修补术。在疝环充填式疝修补术的 基础上，将巴德网塞完全放至筋膜后腹膜前间隙，固定网塞仅缝合1针，将内瓣缝在腹横筋膜上，直疝和缺损大的斜 疝须适当缝合筋膜组织重建腹股沟管后壁。结果：手术操作更加简化，手术并发症少。随访中未发现网塞移位、脱出。 有1例复发，但手术证实网塞固定是可靠的，网塞修复缺损是成功的。结论：网塞单针缝合固定法是一种操作简便、 安全和可靠的手术技术，适合临床推广。

Objective To investigate the effect of the technique of plug fixation in mesh-plug hernioplasty. Methods A total of 114 indirect hernias and 43 direct hernias were operated upon from Apr 2003 to Dee 2004. The procedure of the mesh-plug hernioplasty was modified. The Perfix plug was placed completely into the preperitoneal space. The fixation of the plug was accomplished by one of the inner petals with the fascia transversalis. It was necessary in direct hernias and in some indirect hernias that the floor of the inguinal canal be reconstructed by suturing the fascia. Results The procedure of the mesh-plug hernioplasty became simpler with less complications. No plug migration was found in all cases. Only one case of recurrence was found, but re-operation showed the plug fixation was secure and the plug repair successful. Conclusions The technique of the mesh-plug fixation with one suture is easy, safe and effective. It can be applied in Perfix plug repair.