腹腔镜修补多发性腹壁切口疝

目的 探讨腹腔镜修补多发腹壁切口疝的手术方法和应用价值。方法 2008年2月首都医科大学宣武医院普外科收治1例腹部三次手术后共造成腹部四处切口疝的复杂病例，切口疝长径分别为12、9、6及3cm。采用疝修补缝合钉固定腹腔内大面积复合补片，行腹腔镜修补术。结果 腹腔镜一次修补4个腹壁切口疝手术成功，无肠管损伤等并发症，术后随访6个月无腹壁切口疝复发。结论 腹腔镜多发腹壁切口疝修补术安全、有效。在开腹手术中暴露多个缺损的难点，在腹腔镜手术中难度大大降低。腹腔镜多发腹壁切口疝修补术不但具有微创优势，而且更能发挥其技术优势。

Laparoscopic herniorraphy for abdominal multiple incisional hernia

Objective To evaluate the surgical skill and the efficacy of laparoscopic herniorraphy for abdominal multiple incisional hernia.Methods A complicated case of four position abdominal incisional hernia from three times of surgery admitted in February 2008 at Beijing Xuan Wu Hospital of Capital Medical University was treated by laparoscopic herniorraphy with laparoscopic hernia clip and a large composix mesh.Results The length of hernia defects was 12cm,9cm,6cm and 3cm.A laparoscopic herniorraphy was succeed in the case of abdominal multiple incisional hernia without complication of intestinal injury.The case was followed-up for 6 months and no abdominal incisional hernia recurrent.Conclusion Laparoscopic herniorraphy is safe and effective for abdominal multiple incisional hernia. Laparoscopic herniorraphy is simple for the exploration of abdominal multiple incisional hernia defects,but open herniorraphy is more difficult.Laparoscopic herniorraphy is not only a minimally invasive surgery,but also a superior surgical skill for abdominal multiple incisional hernia.