自制电钩在腹腔镜腹股沟斜疝修补术的应用价值

Application of the self-made electric hook in laparoscopic inguinal hernia repair

目的探讨自制电钩在腹腔镜腹股沟斜疝修补术的临床应用。方法分析2013年1月至2015年12月，广东省深圳市蛇口人民医院应用自制电钩腹腔镜腹股沟斜疝修补术（改良TAPP）的患者28例和同期传统法腹腔镜腹股沟斜疝修补术（TAPP）的患者26例，比较两组的手术时间、出血量、并发症、复发情况。结果54例患者均顺利完成手术，无中转开腹病例，随访6～30个月，无复发。应用自制电钩腹腔镜腹股沟斜疝修补术（改良TAPP）并发症出现阴囊水肿1例，通过保守治疗治愈；传统法腹腔镜腹股沟斜疝修补术（TAPP）组术后出现并发症血清肿1例，通过保守治疗治愈；两组并发症、复发比较差异无统计学意义（P〉0．05），两组手术时间、出血量比较差异有统计学意义（P〈0．05）。结论应用自制电钩腹腔镜腹股沟斜疝修补术治疗腹股沟斜疝具有明显缩短手术时间，减少出血、降低手术难度、提高手术安全性的优势，值得临床进一步推广应用。

Objective To explore the clinical application of self-made electric hook in laparoscopic indirect inguinal hernia repair. Methods From January 2013 to December 2015, a total of 28 patients underwent laparoscopic indirect inguinal hernia repair with beak-like electrocoagulation instrument as modified TAPP, in the same period, 26 patients with traditional TAPP were collected and analyzed. The operation time, blood loss, complications and recurrence were compared. Results 54 patients were successfully completed surgery without conversion. Patients were followed up for 6 to 30 months, no recurrence was found. With the self-made electric hook in modified TAPP, 1 case of scrotal edema occurred, and cured by conservative treatment ; In traditional TAPP group, there was 1 case of postoperative seroma, which cured by conservative treatment. There was no significant difference between the 2 groups in terms of complications and recurrence （ P 〉 0.05 ）. However, the difference in operation time and blood loss were significant （P 〈 0.05 ）. Conclusion Using self-made electrical hook in laparoscopic inguinal hernia repair of indirect inguinal hernia has the advantages of shortening operation time, reduce bleeding, easing the difficulty of operation, and improving the safety of surgery, it is worthy of further clinical application.