改良完全腹膜外腹腔镜疝修补术24例报告

Modified totally extraperitoneal prosthetic of the inguinal hernia by laparoscopy:with a report of 24 cases

目的:探讨改良完全腹膜外腹腔镜疝修补术网片固定方法的可行性和临床疗效。方法:2006年8月至2007年3月我院采用自制水囊分离扩张手术区的腹膜外间隙,充气建立手术空间,术中不固定网片,对25例腹股沟疝患者行改良完全腹膜外腹腔镜疝修补术(totally extraperitoneal prosthetic,TEP)。结果:24例手术成功,1例中转行经腹腔腹膜前固定网片修补法(transabdominal preperitoneal prosthetic,TAPP)。手术时间65～186min,平均98min。术后2～3d出院。术后2例出现腹股沟区牵拉感,1例阴囊积液,无血清肿、神经痛等其他并发症发生。结论:腹腔镜改良TEP安全有效,并发症少,是可行的无张力疝修补术,具有术后患者疼痛轻,康复快、复发率低等优点。

Objective：To explore the feasibility and clinical effect of improved totally extraperitoneal prosthetic （TEP） procedure by laparoseopy. Methods： Twenty-five eases were performed the TEP by established the operative space with separating and expanding extraperitoneal space and infusing air used hydrocyst and unfixed net patch in the operation from Aug. 2006 to Mar. 2007. Results： Twenty-four cases were performed successfully. One case was converted to transabdominal preperitoneal prosthetic （TAPP）. The operative time ranged from 65 to 186min, with an average of 98min. Hospitalization was 2 to 3 days. 2 cases fell tension in groin, 1 case had hydrops in scrotum. Any case had no hematoma and neuralgia. Conclusions： Improved TEP is simple and safe. It is an operation of seldom complications to treat the groin hernia and light pain,recovery quickly, recurernce rate low.