经脐单孔腹腔镜全腹膜外腹股沟疝修补术的临床研究

Clinical study of laparoscopic total extraperitoneal repair of inguinal hernia

目的探讨应用经脐单孔腹腔镜下全腹膜外腹股沟疝修补术的安全性及有效性,总结其临床应用经验。方法回顾分析2010年1月～2011年12月应用经脐单孔腹腔镜下全腹膜外腹股沟疝修补术治疗48例腹股沟疝患者的临床资料。48例患者中斜疝35例,直疝6例,双侧疝5例,复合性疝2例。结果 48例手术均获成功,无一例中转开放手术,手术时间60～150min,术后住院3～7d。1例发生血清肿,抽液后治愈,所有病例术后均无疼痛及阴囊血肿发生,伤口愈合佳。术后随访3～26个月,无复发病例。结论应用经脐单孔腹腔镜下全腹膜外腹股沟疝修补术安全有效,具有术后患者康复快,并发症少,复发率低等优点,值得临床推广和应用。提高手术技巧、降低手术难度是单孔腹腔镜发展的方向。

Objective To study the safety and efficacy of single-laparoscopic surgery for totally extraperitoneal laparoscopic inguinal prosthesis,summarize clinical experience. Methods A retrospective analysis was made on the clinical data of 48 petients undergoing single incision totally extraperitoneal inguinal hernia repair from Jan.2010 to Dec.2011. It included 35 cases of indirect hernia,6 cases of direct hernia,Scases of bilateral hernia,2 cases of compound hernia. Results All operations were successful,without conversion to open operation. Operative time was 60-150 min,and postoperative hospital stay was 3-7 d,with an average of 4 d. There were no patients suffering from postoperative pain or scrotal hematoma.1 cases got seroma,which was healed after drainage.Within the follow-up of 3-20 months,no recurrence occurred. Conclusion Single incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair is a safe and effective surgery with advantages of more rapid recovery,fewer complications and lower recurrence rate. It is worthy of being generalized. To improve the technique of operation and to reduce the difficulty of operation are the direction for single incision laparoscopic surgery.