改良腹腔镜腹腔内置片联合海诺特治疗老年腹股沟疝

Modified Laparoscopic Intraperitoneal Onlay Mesh(IPOM) Combined with Sodium Hyaluronate in the Treatment of Inguinal Hernia in Elderly

目的：探讨改良腹腔镜腹腔内置片（intraperitoneal onlay mesh，IPOM）联合海诺特（透明质酸钠）治疗老年腹股沟疝的优越性。方法：2002年1月至2006年6月，应用腹腔镜腹腔内补网片法联合海诺特治疗100例老年腹股沟疝（其中嵌顿疝15例，双侧疝20例，复发疝10例）。结果：100例均在腹腔镜下完成手术，手术时间20-50min，平均35min，术中无并发症，出血量少。住院3-7d，平均5d。术后恢复顺利，无腹腔感染、阴囊血肿和慢性疼痛。随访12-48个月，平均26个月，无复发、肠粘连、肠梗阻。结论：改良腹腔镜腹腔内置片（IPOM）联合海诺特（透明质酸钠）治疗老年腹股沟疝安全可行，且手术创伤小，康复快，住院时间短，不易复发，无肠粘连等并发症。

Objective： To explore the effect and prosperity of modified laparoscopic intraperitoneal onlay mesh （IPOM ） combined with sodium hyaluronate in the treatment of inguinal hernia in elderly. Method： Modified laparoscopic intraperitoneal onlay mesh （IPOM ） combined with sodium hyaluronate was performed in 100 elderly patients with inguinal hernia from January 2002 to June 2006（ including 15 cases of incarcerated hernia,20 cases of bilateral hernia and 10 cases of recurrent inguinal hernia ）. Result： The operation was successfully performed in all 100 patients. The operative time was 20 -50 minutes（average 35 minutes）. No complication was found and bleeding was less intraoperatively. The hospitalization was 3 - 7days. The postop- erative recovery was uneventful without infection, hematoma of the scrotum and chronic pain. Follow - up ranged from 12 months to four years no relapse was found. Conclusion： Modified the intraperitoneal onlay mesh repair combined with sodium hyaluronate may be a feasible, safe and effective procedure in the treatment of inguinal hernia in elderly, with advantage of mini - invasion, no intestinal adhesion, short operation time, low recurrent rate and quick recovery.