腹腔镜腹股沟疝修补术式选择及注意事项

Selection and attention of laparoscopic inguinal hernia repair

腹腔镜腹股沟疝修补常用术式包括经腹腹膜前疝修补术(TAPP)、全腹膜外疝修补术(TEP)及腹腔内补片修补术(IPOM)。IPOM操作简单,选择防粘连补片,适合复发疝等特殊类型疝。TEP手术操作方式与TAPP手术操作基本相同,这两种手术方式在腹腔镜修补腹股沟疝手术的术后并发症、住院时间以及复发率等方面比较无显著性差异。一般发病时间长、疝囊巨大、嵌顿疝、开放后首次复发疝、女性疝等患者首选TAPP;直疝、病史短的疝首选TEP。TEP及TAPP都适合的情况主要取决于术者的熟练程度。

Common procedures for laparoscopic inguinal hernia repair include transabdominal preperitoneal hernia repair (TAPP), total extraperitoneal hernia repair (TEP), and intraperitoneal patch repair (IPOM). IPOM is easy to operate, select anti-adhesion patch, suitable for recurrent hernia and other special types. The operative methods of TEP and TAPP are basically the same, and there is no significant difference between the two methods in the postoperative complications, hospital stay and recurrence rate of laparoscopic inguinal hernia repair. TAPP is the first choice for patients with long onset time, large hernia sac, incarcerated hernia, recurrent hernia for the first time after opening and female hernia. TEP is preferred for hernia with direct hernia and short history. The suitability of both TEP and TAPP mainly depends on the skill level of the surgeon.