腹腔镜技术在切口疝修补术中的应用体会

Laparoscopic mesh repair of incisional hernias

目的探讨腹腔镜下应用补片修补切口疝的手术方法和临床效果。方法回顾性分析我科2006年1月至2008年12月对腹壁切口疝23例施行腹腔镜修补术的临床资料。结果本组成功施行腹腔镜下切口疝补片修补22例,因腹腔内严重粘连中转剖腹手术1例,术中发现多发切口疝3例。本组无手术死亡和肠瘘病例。术后出现疼痛4例,补片周围积液3例。全组获随访4～24个月,平均13.8个月,未见切口疝复发。结论腹壁切口疝病人行腹腔镜下补片修补大多是安全地,还可在术中发现隐性缺损。对腹腔内广泛粘连分离困难者,应及时中转剖腹手术。

Objective To investigate the operative techniques and clinical outcome of laparoscopic incisional hernia repair with mesh. Methods The clinical data of 23 patients with abdominal incisional hernia treated by laparoscopie mesh repair from Jan. 2006 to Dec. 2006 were analyzed retrospectively. Results The operation was successfully performed on 22 patients and one case was converted to open mesh repair because of extensive intra-abdominal adhesion. Prolonged pain occurred in 4 patients, and seroma occurred in 3 patients. No recurrence occurred in any of cases during a follow-up period of 4 to 24 months（average 13. 8 months）. Conclusion The laparoscopic mesh repair could be performed on most ineisional hernia cases safely,and unexpected defects could be discovered imraoperatively. If extensive adhesion interferes with dissection, the procedure should be converted to open repair.