3D腹腔镜联合杂交技术在腹壁巨大切口疝中的应用体会

目的:探讨3D腹腔镜联合杂交技术治疗腹壁巨大切口疝的临床效果。方法:回顾分析2012年5月至2016年4月为25例腹壁巨大切口疝患者行3D腹腔镜联合杂交技术腹壁切口疝无张力修补术的临床资料,记录围手术期情况,总结其治疗效果。结果:25例患者均顺利完成手术,手术时间平均(111.7±11.3)min,切口长度平均(7.1±3.5)cm,术中出血量平均(55.1±7.7)ml,术后平均住院(6.7±1.6)d;4例患者术后使用止痛剂。术中肠道浆膜损伤1例,未影响补片修补;术后切口轻度感染1例,积极治疗后痊愈,未取出补片,无血清肿、肠瘘等其他并发症发生。术后随访24个月,随访率100%,无一例复发。结论:3D腹腔镜联合杂交技术治疗腹壁巨大切口疝是安全、有效、可行、实用的,治疗效果较好,结合了腹腔镜与开放手术的优点,术后患者康复快,美容效果好,值得临床推广应用。

The application of 3D laparoscopy combined with hybridization technique in abdominal giant incision hernia

Objective:To explore the curative effect of 3D laparoscopy combined with hybridization technique in the treatment of abdominal giant incision hernia .Methods:Clinical data of 25 patients who suffered from huge abdominal incision hernia and under-went 3D laparoscopic combined with hybridization technique repair of abdominal incision hernia without tension form May 2012 to Apr. 2016 were retrospectively analyzed .The perioperative situations were recorded and the treatment outcomes were summarized .Results:All 25 operations were completed successfully .The average operation time was (111.7 ±11.3) min and the average length of incision was (7.1 ±3.5) cm.The average amount of bleeding during operation was (55.1 ±7.7) ml and the average postoperative hospital stay was (6.7 ±1.6) d.4 patients used analgesics after operation .1 case of intestinal serosa injury occurred during operation and didn't af-fect the patch repair .1 case of slight incision infection was found after operation .After active treatment ,incision healed and didn't lead to removal of the patch .There were no complications such as seroma ,intestinal fistula and so on .All the patients were followed up for twenty-four months,there were no postoperative recurrence .Conclusions:3D laparoscopy combined with hybridization technique in the treatment of abdominal giant incision hernia is safe ,effective,feasible and practical ,and can achieve good therapeutic effect .This proce-dure combines the advantages of laparoscopic and open surgery with quick postoperative recovery and satisfactory cosmetic results ,is worthy of clinical generalization .