经腹腹膜前腹腔镜疝修补术治疗腹股沟复发疝

Clinical Experience of Transabdominal Preperitoneal Inguinal Herniorrhaphy for Recurrent Inguinal Hernia

目的：探讨经腹腹膜前腹腔镜疝修补术（ transabdominal preperitoneal inguinal herniorrhaphy ，TAPP）在治疗腹股沟复发疝中的效果。方法回顾性分析我院2010年6月～2013年12月TAPP治疗腹股沟复发疝28例的临床资料。单侧疝25例，双侧疝3例（2例为术中发现）。斜疝13例，直疝15例。结果28例均获成功，无中转手术。手术时间（60＆#177;15） min，术中出血量（30＆#177;5）ml，术后住院时间（4＆#177;1）d。3例术后腹股沟区轻微疼痛不适，口服非甾体止疼药后缓解；4例血清肿，2例自行吸收，2例经多次穿刺抽液后治愈。随访时间1～24个月，平均17个月，其中20例＞12个月，均未见复发。结论 TAPP治疗腹股沟复发疝避免了传统前入路的解剖复杂性，手术安全、有效。

Objective To explore the effect of transabdominal preperitoneal inguinal herniorrhaphy （ TAPP） on the treatment of recurrent inguinal hernia . Methods The clinical data of 28 cases of recurrent inguinal hernias treated by TAPP from June 2010 to December 2013 in our hospital were analyzed retrospectively .It included 25 cases of unilateral hernia and 3 cases of bilateral hernia （ including 2 cases found during the surgery ）;13 cases of indirect hernia and 15 cases of direct hernia . Results All 28 cases of TAPP were completed successfully .The operative time was （ 60 ＆#177;15 ） min, the intraoperative blood loss was （ 30 ＆#177;5 ） ml and the length of postoperative hospital stay was （4 ＆#177;1） d.Three patients had slight inguinal pain and relieved after taking non-steroidal anti-inflammatory drugs orally;4 patients had scrotal seroma , which were absorbed in 2 cases and cured by repeated paracentesis .All the cases were followed up for 1-24 months （average, 17 months）, among which 20 cases were followed up for more than 12 months.No recurrence was found . Conclusion TAPP is safe and effective for recurrent hernia , and free from separating complicated tissue adhesion required by traditional open surgery .