3D补片腹壁悬吊法经腹腹膜前疝修补术71例

3D mesh with abdominal wall suspension in transabdominal preperitoneal hernia repair: a series of 71 cases

目的分析3D补片腹壁悬吊法经腹腹膜前疝修补术（TAPP）的临床疗效。方法回顾性分析2011年1月至2014年7月,山东烟台青岛大学附属烟台毓璜顶医院采用腹壁悬吊法固定3D补片行TAPP术71例的临床资料,总结手术要点及临床体会。结果本组患者均在腹腔镜下完成,单侧疝手术时间50-100 min,双侧疝手术时间90-140 min,术中出血极少,均未置引流,术后2-5 d出院。术中腹壁下动脉损伤1例,行腹腔镜下缝扎止血,术后发生腹股沟区或阴囊血清肿5例,经观察1个月余,均逐渐自动吸收;无腹股沟区感觉异常,术后随访1-12个月,平均6个月,无复发。结论 3D补片腹壁悬吊法TAPP术相对简单、有效、低风险、更经济,适合早期开展腹腔镜疝手术的人员学习。

Objective To analyze the clinical effectiveness of 3D mesh with abdominal wall suspension in transabdominal preperitoneal hernia repair（ TAPP）. Methods A total of 71 cases of inguinal hernia who underwent TAPP using 3D mesh with abdominal wall suspension in Yantai Yuhuangding Hospital from January 2011 to July 2014 were retrospectively analyzed,in order to summarize the operation skills and clinical experience. Results All cases in this series were performed under laparoscopy. The operating time was 50 to 100 minutes in unilateral hernia operation,and 90 to 140 minutes in bilateral hernia operation.With little intraoperative bleeding and no drainage,the patients were discharged in 2 to 5 days. 1 case of epigastric artery injury occurred during the operation,meanwhile,the laparoscopic bleeding suture was performed. Postoperative inguinal or scrotal seroma was found in 5 cases,which were gradually self-absorbed in 1 month of observation. After a mean follow-up of 6 months（ range 1 to 12 months）,no recurrence and no abnormal sensation in groin were observed. Conclusion 3D mesh with abdominal wall suspension in TAPP is relatively safe,effective,more economical and easy to perform,and it is suitable for surgeons,who just begin to learn laparoscopic hernia repair.