腹横筋膜部分切开有利于正确分离耻骨肌孔的体会

Transversalis fascia is partially cut internal ring augmentation in favor of separation of the right pubic muscle hole

目的探讨如何正确分离出耻骨肌孔及其在腹股沟区无张力疝修补术中的意义。方法对47例行腹膜前间隙修补术的患者扩大内环口,清楚暴露耻骨肌孔后平铺各层补片,并再次缩小内环口。结果本组患者手术时间30～50min,术中未出现血管、精索及膀胱损伤,术后4～7d痊愈出院。术后阴囊轻度水肿1例,3d后消退,无围手术期死亡。随访3～12个月,无复发。结论扩大内环口有利于暴露耻骨肌孔,方便补片的放入,能够更好地达到全腹股沟疝的修补,并未延长手术时间,减少术中出血、术后疼痛,适合在低年资医师及基层医院推广。

Objective To study how to correctly separate the annulus inguinalis profundus and its significance on tension-free hemioplasty. Methods A total of 47 patients with preperitoneal herniorrhaphy were taken with internal ring gap. Layers of patches for myopectineal were exposed. The annulus inguinalis profundus was narrowing. Results The operation duration was 30 to 50 minutes. No blood vessels, spermatic cord, and bladder injury were observed. The patients were discharged 4 to 7 days after hospitalization and one case of mild edema was observed and subsided after 3 days without perioperative deaths. The patients were followed up with 12 months without recurrence. Conclusions It is benefit to expose pubic muscle hole via expanding internal ring and convenient for patching to enable full inguinal hernia repair, which does not extend the operation time, reduce blood loss, postoperative pain and be suitable for junior physicians and lower- level hospitals.