完全腹膜外腹腔镜腹股沟疝修补术的临床应用

目的总结完全腹膜外腹腔镜疝修补术（TEP）的临床应用体会和经验。方法回顾分析2006年1月至2007年8月江西省赣县人民医院收治46例腹股沟疝患者行TEP手术的临床资料。直疝12例、斜疝34例；单侧疝36例、双侧疝10例，其中复发疝6例。结果全部患者均成功施行完全腹膜外腹腔镜腹股沟疝修补术，无中转开腹。手术时间82～180min（平均单侧95min、双侧110min）。术后无须使用镇痛剂，住院时间3～10d，平均5d。主要并发症阴囊血肿4例，血清肿2例。随访1～16个月，术后无复发。结论TEP手术安全可靠，具有并发症少、术后疼痛轻、康复快、复发率低等优点，可同时对双侧疝进行处理，无需全身麻醉，使用硬膜外麻醉即可，具有明显的优越性，有广泛的应用前景，值得临床推广。

Clinical application of total extraperitoneal laparoscopic herniorrhaphy

Objective To summarize therapeutic effect and experience of total extraperitoneal laparoscopic herniorrhaphy（TEP）. Methods Between January 2006 to August 2007,46 patients were performed total extraperitoneal laparoscopic hernia repairs for inguinal hernia,including 12 direct inguinal hernia and 34 indirect inguinal hernia operations. Among 46 patients ,36 patients had unilateral hernia and 10 patients had bilateral hernias,including 6 recurrent hernia. Results All patients were performed successfully by endoscopic TEP hernioplasty,with operating time from 82-180 minutes. The mean operating duration was 95 minutes for unilateral hernia and 110 minutes for bilateral hernia. The patients didn＇t need analgesics. The patients stayed in hospital for 3 -10 days. The mean inpatient hospital stay was 5 days. Postoperative complications include 4 cases of hematoma of scrotum and 2 cases of seroma of scrotum. There was no recurrence after 1 ~ 16 months follow-up. Conclusion The procedure of TEP is safe, with faster postoperative recover, less pain and lower recurrence rate, thus worth being widely used clinically.