应用三维立体补片行免固定腹腔镜经腹膜前腹股沟疝修补术

目的总结应用三维立体补片(3DMAX补片)行免固定腹腔镜下经腹腹膜前补片植入术(TAPP)的经验、技巧及体会。方法回顾性分析2009年7月至2012年1月大连医科大学附属第一医院普通外科应用3DMax补片行免固定腹腔镜腹股沟疝修补术的47例患者。结果全部手术均获成功,47例患者行56侧腹腔镜TAPP术,单侧疝手术时间28～85 min,双侧疝手术时间38～98 min,术后第3周96%患者恢复正常活动,57%恢复运动,发生阴囊血清肿3例,1例轻度疼痛,肠梗阻1例。随访6～28个月,1例复发。结论三维立体补片(3DMax补片)免固定腹腔镜下经腹腹膜前补片植入术(TAPP)是一种安全可靠的疝修补术,具有操作简便易行,复发率低等优点,特别适于复发疝、双侧疝等,值得推广应用。但有补片移位的风险。

Laparoscopic Inguinal Hernia Repair Using an Anatomically Contoured Three-dimensional Mesh without Fixation

Objective To summary the experience and skills of laparoscopic transabdominal preperitoneal hernia repair（TAPP） using three-dimensional mesh （ 3DMax mesh ） without fixation. Methods Retrospectively analysis laparoscopic inguinal hernia repair using 3DMax mesh without fixation which was applicated in 47 patients by General Surgery department in the First Affiliated Hospital of Dalian Medical University, from July 2009 to January 2012. Results The operation for all patients was performed successfully under the laparoscope, in which 47 patients with the laparoscopic TAPP surgery 56 cases,with operating time from 28 to 85 minutes for unilateral hemioplasty, from 38 to 98 minutes for bilateral hemioplasty.About 96% of the patients return to normal activities and 57% of the patients restore movement after three weeks, Only 3 case of scrotal serum happened after operation,1 case had minor pain, and small bowel obstruction was occurred in 1 case. Only 1 case recurrence was found in follow-up for 6~28 months.Conclusions Laparoscopic transabdominal preperitoneal hernia repair（TAPP）,using three-dimensional mesh （3DMax mesh） without fixation ,which is safe, reliable and simple, with low complication rate, is especially suitable for bilateral and recurrent hernia. It deserves to be expanded~ but it has the risk of mesh shift.