解剖型补片在腹腔镜全腹膜外疝修补术中的应用  

Application of anatomical mesh in totally extraperitoneal hernia repair under laparoscope

作　　者：王以东[1] 龚航军[1] 韩刚[1] 曹羽[1] 张云[1] 

机构地区：[1]上海中医药大学附属曙光医院胃肠外科,上海201203

出　　处：《外科研究与新技术》2016年第1期23-25,共3页Surgical Research and New Technique

摘　　要：】目的总结使用解剖型补片行腹腔镜全腹膜外（totally extraperitoneal，TEP）疝修补术治疗腹股沟疝的临床经验。方法回顾分析2011年6月-2014年6月我院采用TEP放置解剖型补片治疗54例腹股沟疝的临床资料。结果本组手术均获成功，无中转其他术式，手术时间35～115min（平均单侧48min，双侧105min），术中出血5～50mL。但有术中腹膜破裂并致气体进入腹腔者9例，插入气腹针排气后完成手术；术后假性疝囊积液1例，穿刺后吸收；术后暂时眭神经感觉异常1例，术后1月恢复。住院时间3-6d（平均3．7d），随访1-4年无腹股沟区慢性神经痛和复发病例。结论选用无需裁剪、操作简便、符合解剖结构、异物感小的解剖型补片的TEP疝修补术安全可靠、痛苦小、恢复快，是腔镜下治疗腹股沟疝尤其疝囊直径小于4cm的Ⅰ型、Ⅱ型腹股沟疝的首选术式。Objective To summarize the clinical experience of totally extraperitoneal （TEP） hernia repair under laparoscope by using anatomical mesh for inguinal hernia. Methods The clinical data of 54 patients with inguinal hernia undergoing TEP hernia repair by using anatomical mesh in our hospital from June 2011 to June 2014 were retrospectively analyzed. Results Surgery was successfully carried out in all cases, with the operation duration of 35 to 115 min （unilateral 48 min and bilateral 105 min in average）, volume of blood loss of 5 to 50 ml, and no transfer to the other surgical procedures. Nine cases had intraoperative peritoneal rupture causing gas to enter the abdominal cavity, and surgery was successfully performed after air discharge by inserting Veress needle. One case had postoperative pseudo-sac effusion, and was absorbed after puncture. One case experienced postoperative temporary nerve paresthesia, and recovered 1 month after surgery. The patients were hospitalized for 3 to 6 d, with an average of 3.7 d. There was no case of chronic neuropathic pain in the groin area and recurrent hernia after follow up for 1 to 4 years. Conclusion TEP hernia repair by using anatomical mesh is safe and reliable, with unnecessity for cutting, simple operation, compliance with anatomical structure and little sense of foreign bodies, thus is a preferred surgical procedure under laparoscope for inguinal hernia,particularly for type I and II inguinal hernia with less than 4 cm in hernial sac diameter.

关 键 词：腹腔镜 腹股沟疝 全腹膜外腹腔镜疝修补术 解剖型补片 

分 类 号：R656.21[医药卫生—外科学]