免气囊分离器无钉合完全腹膜外腹腔镜疝修补术的临床应用（附46例报告）

目的探讨免气囊分离器无钉合完全腹膜外腹腔镜疝修补术（totally extraperitoneal laparoscopic hernia repair，TEP）的临床应用价值。方法回顾性分析我院自2005年1月-2007年8月采用免气囊分离器无钉合技术完成TEP 46例（50例次）的临床资料。结果本组均成功完成手术，平均手术时间68min。病人术后住院2～6d，平均3．2d。主要并发症为皮下气肿2例．腹股沟区血清肿1例。术后未出现持续性神经性疼痛、切口感染及补片感染。术后随访3～21个月，未见复发病例。结论免气囊分离器无钉合TEP是一种安全、可靠的疝修补方法，具有切口小、术后疼痛轻、恢复快、复发率低等优点。且能明显降低手术费用，在疝修补术中具有较大优势，值得推广。

Clinical application of totally extraperitoneal laparoscopic hernia repair with non-stapling of mesh and using no balloon dissector:A report of 46 cases

Objective To explore the value of totally extraperitoneal laparoseopic hernia repair （TEP）with non-stapling of mesh and using no balloon dissector in clinical application. Methods TEP was performed on 46 patients from Jan. 2005 to Aug. 2007. The clinical data of the cases were retrospectively analyzed. Results All cases were operated successfully. The mean operative time was 68 min and the average postoperative stay was 3.2（2-6）days. Most complications included subcutaneous emphysema（2 cases）and inguinal hematoma（one case）. There were no complications of persistent nervous pain,wound infection and onlay mesh infection after operations. All patients were followed up for 3- 21 months and there were no recurrent patients. Conclusion TEP with non-stapling of mesh and using no balloon dissector is safe and effective for inguinal hernia with advantages of small incision, less pain, quick recovery and low recurrence.