“颈-肩”技术在188例腹股沟斜疝修补术中的应用体会  

Clinical experiences of "Neck-shoulder" technique in repairing 188 cases of indirect inguinal hernias

作　　者：孙荣勋[1] 章勇[1] 顾超[1] 周亮[1] 俞建平[1] 

机构地区：[1]复旦大学附属金山医院普外科,上海200540

出　　处：《外科理论与实践》2011年第2期181-184,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:"颈-肩"技术是腹股沟斜疝腹膜前修补术的关键步骤,我们将该技术扩展应用于筋膜前修补,探讨其价值。方法:188例腹股沟斜疝病人,分别使用Lichtenstein、Rutkow、Millikan等手术方式修补,所有病例手术均贯彻"颈-肩"技术,即在游离精索后,于内环处切开腹横筋膜,直接显露疝囊颈部,将疝囊高位游离至疝环切开水平,并继续向近端分离内脏囊("肩")与腹横筋膜间的粘连,显露腹膜前间隙。观察术中情况、术后短期和远期并发症。结果:手术操作顺利,平均手术时间50 min,术中出血少,并发症发生率低,术后未复发。结论:"颈-肩"技术在腹股沟斜疝手术中具有操作简便、解剖清晰、损伤轻微、修补确切的优点。Objective ＂Neck-shoulder＂ technique is an essential step of preperitoneal hernioplasty in indirect inguinal hernia patients.The technique was expanded to be applied in prefascial henioplasty,the value of which was studied.Methods 188 patients were treated separately with Lichtenstein,Rutkow,Millikan procedures.＂Neck-shoulder＂ technique was taken in all the cases as follows.The fascia transversalis was dissected to approach the ＂neck＂ of hernia sac directly at the internal inguinal ring after dissecting off the spermatic cord delicately.The hernia sac was then separated to above internal ring level,followed by separating the visceral sac（＂shoulder＂） from the fascia transversalis for gaining access to the Bogros space.The operative data,short-term and long-term postoperative complications were observed.Results All operations were performed smoothly.Average operating time was fifty minutes.There were little intraoperative bleeding,the postoperative complication rate was lowered and no recurrence occurred.Conclusions ＂Neck-shoulder＂ technique applied in indirect inguinal hernioplasty can help to provide simple process,clear anatomy,little accessory injury and reliable repair.

关 键 词：“颈-肩”技术 腹股沟疝 疝修补术 

分 类 号：R656.21[医药卫生—外科学]