腹腔镜完全腹膜外免钉合腹股沟疝修补术45例

目的探讨腹腔镜完全腹膜外免钉合腹股沟疝修补术的可行性和安全性。方法 2007年1月~2010年3月我院对45例(52侧)腹股沟疝行腹腔镜完全腹膜外疝修补术,用镜头替代气囊分离器分离腹膜前间隙,用预成形巴德3D Max补片无钉合固定。结果 45例手术全部成功,手术时间(65.8±21.8)min,术中出血量(15.3±4.6)ml,术后住院时间(2.7±1.2)d。术后阴囊血清肿1例,局部穿刺抽液3次及理疗1个月后治愈。45例随访1~38个月,平均15.6月,其中随访1年36例,未见复发及腹股沟区慢性疼痛等并发症。结论免钉合TEP是一种可行、安全、有效的无张力疝修补技术。

Laparoscopic Total Repair of Extraperitoneal Inguinal Hernia without Mesh Stapling: Report of 45 Cases

Objective To explore the feasibility and safety of laparoscopic total extra peritoneal hernia repair without mesh stapling for inguinal herniorrhaphy.Methods Between January 2007 to March 2010,45 patients underwent 52 total laparoscopic extra peritoneal hernia repairs for inguinal hernia in our hospital.Endoscope was employed instead of a dissection balloon to separate the preperitoneal space,and Bard 3D mesh was used for fixation without stapling.Results All the operations were successfully completed in the 45 cases within（65.8±21.8） minutes with a mean blood loss of（15.3±4.6） ml.The postoperative hospital stay was（2.7±1.2） days.One patient developed scrotal hematoma after the operation,and was cured after pumping fluid through a puncture for three times and physical therapy for one month.The patients were followed up for 1 to 38 months with a mean of 15.6 months（1 year in 36 cases）;no recurrence nor chronic pain in the surgical area were found during this period.ConclusionLaparoscopic total extra peritoneal hernia repair with non-stapling of mesh is a feasible,safe and efficient tension-free technique for inguinal hernia.