免钉合改良完全腹膜外腹腔镜疝修补术61例次报告

目的:探讨免钉合改良腹腔镜完全腹膜外疝修补术(totally extraperitoneal prosthesis,TEP)的可行性、安全性及易推广性。方法:2007年8月至2008年8月我院于硬膜外麻醉下行免钉合腹腔镜改良TEP61例次。术中不固定补片。结果:58例次成功行TEP,3例次中转行经腹腔腹膜前修补术。手术时间38～196min,平均手术时间单侧75min,双侧115min。术后未使用镇痛剂,住院时间3～10d,平均5.5d。主要并发症为阴囊积液或血肿6例次(9.8%),阴囊积气3例次(4.9%)。无其他并发症发生。随访3～14个月,无复发及腹股沟区慢性疼痛等并发症发生。结论:免钉合改良TEP是一种安全、可行、易推广的无张力疝修补术,能明显减少手术费用并获得经济效益,术后患者疼痛轻,康复快,复发率低。

Modified laparoscopic totally extraperitoneal prosthesis without nails:with a report of 61 case-times

Objective:The objective is to improve the feasibility,safety of the totally extraperitoneal prosthesis (TEP).Methods:The TEP had been put into practice 61 times under epidural anesthesia from Aug.2007 to Aug.2008,and no patch was fixed during the operations.Results:Fifty-eight cases are successful,and 3 cases turned to transabdominal preperitoneal prosthesis.The operation time varied from 38 to 196min,and the average time of single side was 75min,while both sides was 115min.It was not necessary to use pain killer after operation.The patients had to stay in hospital for 3-10d,while the average time was 5.5d.The main complication was the scrotum hydrocele and scrotal hematoma in 6 cases (9.8%),the scrotal pneumatosis in 3 cases (4.9%).There was no chronic pain in groin area or recurrence during the following 3-14 months.Conclusions:TEP is a viable,safe,easy to promote tension-free hernioplasty which chould significantly reduce the cost,the suffer of patients and the recurrence rate of hernia.