腹腔镜下行疝修补术的75例经验

Laparoscopic Hernioplasty in 75 Patients.

目的 :探讨腹腔镜腹股沟疝修补手术的方法、适应证及优缺点。方法 :75例腹股沟疝用腹腔镜进行了疝修补术 ,其中斜疝 5 3例 ,不完全性疝 8例 ,直疝 14例。行单纯疝囊高位结扎 10例 ,经腹腔腹膜前补片植入术 (TAPP)4 8例 5 2侧疝 ,完全腹膜外行补片植入术 (TEP)者 17例。结果 :手术全部成功完成 ,平均手术时间 6 2 .5 (10～ 180 )min ,无中转手术 ,8例病人同时行了阑尾切除术 ,4例病人同时行了胆囊切除术 ;术后平均 5 .4d出院。 1例直疝于TAPP术后 8月因补片过小而复发。结论 :腹腔镜疝修补术是一种安全而先进的无张力疝修补手术 ,手术后恢复时间短 。

Objective: To explore the methcds, indications of laparoscopic hernioplasty and its advantage and disadvantage. Methods: From Jun.1995 through Dec.2001, 75 patients with inguinal hernia were treated by the laparoscopic technique. There were 53 cases of indirect inguinal hernia, 14 cases of direct inguinal hernia and 8 cases of small hernia. The laparoscopic transabdominal preperitoneal patch repair(TAPP) was performed in 48 patients. Closure of the internal ring was performed in 10 patients. Laparoscopic totally extraperitoneal patch repair was performed in 17 patients. Results: All operations ended successfully. The average time of operation was 62.5 (10～180) min. The average duration of postoperative stay was 5.4 (2～7) days. There was no conversion into open surgery. Except in one case where the mesh used for repair was proved to be too small, there was no other long-term recurrences. Conclusions: The laparoscopic mesh repair of hernias is a satisfactory technique with a low recurrence rate and a low major complication rate.