免分离器不钉合补片的腹腔镜全腹膜外疝修补术的手术技巧及疗效  

Techniques and effects of laparoscopic total extraperitoneal hernia repair without using dissection ballon and stapling patch

作　　者：黄华[1] 李红春[1] 赵振献[2] 吴志棉[2] 

机构地区：[1]深圳市第三人民医院肝胆外科,广东深圳518020 [2]中山大学附属第一医院微创外科,广东广州510010

出　　处：《中国现代普通外科进展》2009年第6期497-499,539,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨免气囊分离器不钉合补片的腹腔镜全腹膜外疝修补术(total extraperitoneal repair,TEP)的手术技巧,同时评价该术式与开放性无张力疝修补术的优缺点。方法:93例腹股沟疝患者,其中39例行免气囊、不钉合补片的TEP术(TEP组),54例行开放性无张力疝修补术(开放组)。结果:TEP组单侧疝手术时间(101.3±15.6)min,双侧疝手术时间(138.4±17.3)min,术中损伤血管3例,腹膜破裂3例,术后阴囊血肿2例,腹股沟区长期疼痛1例,无切口感染及术后复发。开放组单侧疝手术时间(81.6±7.6)min,双侧疝手术时间(175.8±22.0)min,术后阴囊血肿9例,腹股沟区长期疼痛6例,切口感染4例,无术后复发。结论:免气囊分离器不钉合补片的TEP同样安全、可靠,术后并发症较少,尤其适合于双侧疝。Objective： To study the feasibility of surgical techniques and clinical experience of the airbag-free separation of nail and the whole extraperitoneal laparoscopic hernia repair （TEP）. Methods： Ninty-three cases of inguina hernia. Patients were treatecl in our hospital from March 2005 to January 2009, with 39 cases of regular. Free air and non-stapling of mesh TEP and 54 cases of routine open tension-free hernioplasty. Results： The operation times were as follows： TEP Group, unilateral hernia （101.3 ± 15.6 rain）, bilateral hernia （138.4 ± 17.3 min）; Open Group, unilateral hernia （81.6 ± 7.6 min）, bilateral hernia 175.8 ± 22.0 min. The couplications in TEP Goup inclucled 3 cases of retroperitoheat rupture, 3 cases of intra-operative vascular injury, and 2 cases of postoperative scrotal hematoma. Nine cases of sacrotal hematoma, 4 cases, of infective and 6 cases of long-term pain in the groin area happened in open Group. Conclusion： TEP of free balloon separator with no stapling patch is safe, reliable, less post-operative complications and especially suitable for bilateral hernia.

关 键 词：腹腔镜检查 免气囊分离器 补片固定 疝 腹股沟 

分 类 号：R656.21[医药卫生—外科学]