腹腔镜治疗腹股沟疝时子宫圆韧带的处理方式及术后对女性生育能力的影响

Effect of uterine round ligament tackling ways on laparoscopic inguinal hernia repair and female fertility

腹腔镜治疗腹股沟疝已经成为成人腹股沟疝的主要治疗方法,然而经腹腔镜腹股沟疝修补术中子宫圆韧带是否应该保留仍存在着较大争议。部分学者认为子宫圆韧带由平滑肌及结缔组织组成,并非生殖细胞的排出通道,不必像精索一样"腹壁化",其会增加手术难度和时间,腹腔镜腹股沟疝修补术中可离断子宫圆韧带以达到降低手术难度和时间的目的;另一部分学者则认为子宫圆韧带虽非生殖细胞的排出通道,但对维持子宫的正常解剖学位置具有重要作用,腹腔镜腹股沟疝修补术中应保留子宫圆韧带以达到维持子宫正常前倾前屈位的目的。本文对腹腔镜治疗腹股沟疝时子宫圆韧带处理方式及其可能对女性术后生育能力的影响进行综述。

Laparoscopic treatment has become the main therapy of adult inguinal hernia repair, but there is still a big controversy whether the uterine round ligament should be retained. Some scholars believe that the uterine round ligament is composed of smooth muscle and connective tissue and not like the spermatic cord, which is the germ cell discharge channel and usually need to perform abdominal wall of spermatic cord. Cutting off the uterine round ligament may help laparoscopic inguinal hernia repair surgery and reduce the surgery time. Others believe that the uterine round ligament should be retained, because the uterine round ligament is not the discharge channol of germ cell, but it can maintain the normal ana- tomical position of the uterus. We reviewed on the ways of tackling uterine round ligament in the laparoscopic inguinal hernia repair surgery and its possible influence on female fertility after operative.