经腹腔镜全腹膜外疝修补术24例临床应用体会

Experience of modified totally laparoscopic extraperitoneal repair： A study of 24 cases

目的总结补片增强和疝环充填结合缝合固定补片的经腹腔镜全腹膜外疝修补术（to—talextraperitonealrepair，TEP）的临床应用经验。方法回顾性分析2009年10月至2010年8月收治的行补片增强和疝环充填结合补片缝合固定的TEP手术24例腹股沟疝病人的临床资料。结果全部病例均成功施行TEP。单侧疝手术时间40～70min，双侧疝手术时间70～100min；术中出血10～50ml。术后发生阴囊血清肿1例。术后5～7d出院。随诊6～17个月，无复发病例。结论补片增强和疝环充填结合缝合固定补片的TEP安全、可靠，操作简单、易行，并发症和费用降低。

Objective To summarize the therapeutic effect and experience of reinforcement and fixation of suture mesh during endoscopic total extraperitoneal（TEP） inguinal hernioplasty. Methods Clinical data of 24 patients with inguinal hernia treated by modified totally laparoscopic extraperitoneal repair with reinforcement and mesh plug combined with mesh fixed by suture from October 2009 to August 2010 were retrospectively analyzed. Results All patients were subjected to laparoscopic TEP hernioplasty, The operating time was 4（I to 70 sin for unilateral hernioptasty,and 70 to 100 sin for bilateral hernioplasty. Blood loss was 10-50 ml. There was one case of postoperative seroma of scro- tum. The patients were discharged 5-7 days after operation. During a follow-up period of 6-17 months, there was no recurrence. Conclusion The simplified laparoscopic TEP hernioplasty can be performed safely and reliably. The reinforcement and mesh plug combined with fixation of suture mesh strategy also helps to reduce the cost and complication rate of the operation.