腹腔镜下腹壁切口疝补片修补术的应用

Laparoscopic Repair of Incisional Hernia with Mesh:the Clinical Application

目的总结腹腔镜下腹壁切口疝补片修补术的手术操作要点及其优点。方法回顾性分析2005年1月～2008年12月我院应用腹腔镜下腹壁切口疝补片修补术治疗32例腹壁切口疝患者的临床资料。结果手术均取得成功,手术时间为20～60分钟,平均40分钟。术后住院时间3～6天,平均4.5天。15例患者有腹壁疼痛感觉,发生率46.9%,予镇痛治疗,多于术后3天明显减轻,2～3周后缓解;三例出现血清肿,发生率9.4%,一例予加压包扎后吸收,两例予穿刺抽吸后消失。随访3月～50月,临床症状缓解,未见复发。结论腹腔镜下腹壁切口疝补片修补术做为一种新的手术方法,优势明显。

Objective To summarize the surgical technique of laparoscopic incisional hernia repair. Methods 32 cases of incisional hernia patients were received laparoscopic mesh herniorrhaphy from Jan 2005 to Dec 2008. Data collected from the medical records were analyzed retrospectively. Results All surgeries were successful with no conversion. The average surgery time was 40 min （20-60min）. Mean post-surgery hospital stay was 4.5 d （3-6 d）. 15 patients （46.9%） complained abdominal pain that could be alleviated in 3 d and eliminated in 2-3 w by analgesic medication. Seroma occurred in 3 cases （9.4%）. Regression gained with pressure dressing （1/3） or aspiration （2/3）. A follow-up of 3-50 m showed clinical remissions and no relaose. Conclusion The laoaroscooic approach to incisional hernia is an effective new technique that has obvious advantages.