耻脐入路单孔腹腔镜后鞘后技术在脐疝修补术中的应用

Application of the supraumbilical single-port laparoscopic preperitoneal technique in umbilical hernia repair

目的探讨耻脐入路单孔腹腔镜后鞘后修补术治疗脐疝的临床应用价值。方法回顾性研究2021年6月至2023年8月,上海中医药大学附属普陀医院微创外科收治的18例实施耻脐入路单孔腹腔镜后鞘后疝修补术的脐疝患者,根据临床病例资料、手术操作的技术细节及术后随访情况,分析该术式的临床效果及获益。结果18例患者均顺利完成手术,无中转开放手术,平均手术时间(106.67±28.49)min,术后6~8 h下床活动,术后8、24 h视觉模拟评分分别为2.94、2.50分,术后平均住院时间为(2.02±0.63)d;术后均无出血、肠梗阻、肠瘘、脐部坏死等严重并发症;随访时间为3~28个月,随访率100%,无复发。结论耻脐入路行单孔腹腔镜下后鞘后脐疝修补术安全可行,隐瘢痕效果好,术后疼痛轻,恢复快,可作为腹腔镜下脐疝修补的一种选择术式。

Objective To explore the clinical application value of the supraumbilical single-port laparoscopic preperitoneal repair technique in the treatment of umbilical hernias.Methods This retrospective study reviewed 18 patients who underwent umbilical hernia repair using the supraumbilical single-port laparoscopic preperitoneal technique at the Department of Minimally Invasive Surgery,Putuo Hospital,affiliated with Shanghai University of Traditional Chinese Medicine,from June 2021 to August 2023.The clinical outcomes and benefits were analyzed based on clinical data,technical details of the surgical procedure,and postoperative follow-up.Results All 18 patients successfully underwent surgery without conversion to open surgery.The average operation time was 106.67±28.49 minutes.Patients were encouraged to ambulate for 6 to 8 hours postoperatively.The visual analog scale scores at 8 and 24 hours postoperatively were 2.94 and 2.50,respectively.The average postoperative hospital stay was(2.02±0.63)days.There were no serious complications such as bleeding,intestinal obstruction,enterocutaneous fistula,or umbilical necrosis postoperatively.Follow-up periods ranged from 3 to 28 months,with a 100%follow-up rate and no recurrence observed.Conclusion The supraumbilical single-port laparoscopic preperitoneal umbilical hernia repair technique is safe and feasible,offering excellent cosmetic results with minimal scarring,less postoperative pain,and rapid recovery.It can be considered an alternative technique for laparoscopic umbilical hernia repair.