腹腔镜腹膜前补片修补术治疗老年复发性腹股沟疝18例分析

The experiences of laparoscopic transabdominal preperitoneal herniorrhaphy in the treatment of elderly patients with recurrent inguinal hernia

目的观察经腹腔镜腹膜前补片修补术治疗老年复发性腹股沟疝的临床效果。方法采用腹股沟切口,在内环口上方打开腹腔,经腹腔镜辅助下打开腹膜前间隙放置补片修补老年复发性腹股沟疝18例。手术后随访6个月～2年,观察其治疗效果。结果患者手术时间45～90min,平均55min。手术过程顺利,手术后恢复快,肠蠕动均无明显影响,无切口感染和不适。8例尿潴留留置尿管到第2天。4例阴囊少量积液者自行吸收。住院时间平均为5～7d。随访期间无复发。结论腹腔镜腹膜前补片修补术治疗老年复发性腹股沟疝,具有手术彻底、操作简单、解剖清楚、补片放置准确、并发症少的优点。

Objective To evaluate the efficacy of laparoscopic transabdominal preperitoneal herniorrhaphy in the treatment of elderly patients with recurrent inguinal hernia.Methods The groin incision in the abdominal cavity was opened above the deep internal ring,then abdominal preperitoneal space was opened under laparoscope so as to place repair patch in 18 elderly patients with recurrent inguinal hernia.The follow-up ranged from six months to two years.The efficacy was observed.Results All operations were successful with satisfactory outcomes and no complications.The operating time ranged from 45 to 90 minutes,with the mean of 55 minutes.There was no foreign body sensation and wound infections.8 patients with uroschesis were received indwelling catheter to the next day.4 patients were found with a few accumulating fluid in scrotum whose accumulating fluid was self-absorbed.The average stay ranged from five to seven days.There was no recurrence in follow-up duration.Conclusion Laparoscopic transabdominal preperitoneal herniorrhaphy under direct vision is the effective method to elderly patients with recurrent inguinal hernia with the advantage of operation simplification and few complications.