腹腔镜下改良腹腔内置网法治疗成人腹股沟斜疝

Modified intraperitoneal onlay mesh laparoscopic herniorrhaphy for adult indirect inguinal hernia

目的 总结腹腔镜疝内环口荷包缝扎联合腹腔内置网法（即改良IPOM,intraperitoneal onlay mesh laparoscopic herniorrhaphy）治疗成人腹股沟斜疝的经验. 方法 2004年9月～2005年2月我院采用腹腔镜改良IPOM对15例腹股沟斜疝行腹腔镜疝修补术.结果 手术时间30～60 min,平均35 min,术后2～3 d出院.术后2例患侧腹股沟区出现牵拉不适感,理疗2周后恢复正常.15例随访2～6个月, 平均4.8月,无复发. 结论 腹腔镜改良IPOM治疗成人腹股沟斜疝安全可行,有操作简单、并发症少、术后疼痛轻、恢复快、复发率低、美容效果好等优点.

Objective To summarize the experience of laparoscopic purse-string transfixion of the internal ring combined with intraperitoneal onlay mesh （IPOM） laparoscopic herniorrhaphy in the treatment of adult indirect inguinal hernia. Methods The modified IPOM laparoscopic herniorrhaphy （ laparoscopic purse-string transfixion of the internal ring combined with IPOM laparoscopic herniorrhaphy） was performed in 15 adult patients with indirect inguinal hernia in this hospital from September 2004 to February 2005. Results The time of operation was 30 - 60 min （ mean, 35 min）. The patients were discharged from hospital 2 - 3 days after operation. Two patients complained of tractive discomfort after operation and were cured with postoperative physical therapy for 2 weeks. Follow-up observations in 15 patients for 2 - 6 months （mean, 4.8 months） revealed no recurrence. Conclusions The modified IPOM laparoscopic herniorrhaphy is a safe and feasible option for adult indirect inguinal hernia, with advantages of simplicity of performance, few complications, mild postoperative pain, quick recovery, low recurrence, and good cosmetic results.