腹股沟疝无张力修补术中补片在外环处的固定

Patch fixation in the position of external ring for tension-free repair of inguinal hernia

目的通过改进腹股沟疝无张力修补术耻骨结节缝合方法,减少术后腹股沟疼痛的发生。方法采用耻骨结节腱膜下注射2%利多卡因方法使耻骨结节腱膜明显隆起与骨膜分离,可将补片和耻骨结节腱膜准确缝合。结果术后第7天站立位抬高患侧下肢出现局部腹股沟内侧明显疼痛感:A组17.5%(7/40),B组患者未诉有明显疼痛(0/35),两组差异显著(P<0.05)。结论本手术方法可准确地避开损伤耻骨结节骨膜,能有效地避免术后由于缝合损伤耻骨结节骨膜所引起的术后疼痛。

Objective To improve the method of suture on pubic tubercle in the process of tension-free repair of groin hernia, and to reduce the rate of postoperative pain in the inguinal region. Methods 2% lidocaine was injected under the aponeurosis to make the aponeurosis swelling up that caused the aponeurosis detachment separating from the periosteum on the pubic tubercle. Mesh and the aponeurosis could be exactly sutured. Results 7th day after operation, 7 patients（7/40, 17.5%） in group A felt obviously pain in medial inguinal region when patients stood and raised the leg. The same site with hernia patients,nobody felt pain in group B（0/4O）. The difference was significant（P 〈 0.05）. Conclusion After separating the aponeurosis from the periosteum of the pubic tubercle through distentive pressure of liquid injected under the aponeurosis, Mesh and the aponeurosis would exacdy suture to avoid injuring the periosteum.It can prevent the postoperative pain in the inguinal region by suturing the periosteum of pubic tubercle in the process of tension-free repair of groin hernia.