经济型完全腹膜外腹腔镜腹股沟疝修补术

目的探讨较经济的完全腹膜外腹腔镜腹股沟疝修补术（TEP）的可行性，总结经济型TEP的操作经验，为TEP的推广提供借鉴。方法回顾性分析我院2006年6月至2007年12月对23例腹股沟疝进行TEP的临床资料；采用连续硬膜外麻醉，免气囊扩张器建立腹膜外间隙，使用国产聚丙烯补片且不予钉合固定等系列降低手术成本的手术方法。结果23例腹股沟疝患者腹膜撕裂3例，中转开放手术2例，中转全麻1例（均发生于斜疝）；手术时间40～180min，平均住院5d，住院费用4500．00—5000．00元；术后无疼痛、血清肿、感染、疝复发等并发症发生。结论采用连续硬膜外麻醉，免气囊分离器，国产聚丙烯补片不予钉合固定的TEP是可行的，为其在基层医院的开展提供了借鉴作用。

Economical laparoscopic total extraperitoneal inguinal hernia repair

Objective To explore the feasibility of economical laparoscopic total extraperitoneal repair (TEP) for inguinal hernia, to summarize and provide the experience of economical TEP.Methods The clinical data of 23 cases of inguinal hernia treated by laparoscopic TEP was retrospectively analyzed from June 2006 to December 2007 in our hospital. In order to reduce operation cost, various methods were adopted such as deploying epidural anesthesia, using the domestic polypropylene mesh, non-stapling the mesh and providing spatium extraperitoneale without using the balloon dissector. Results 3 cases abdominal membrane of indirect hernia were lacerated, among which 2 cases was conversed to open surgery and 1 case to general anesthesia. The operation time was 40～180 min, the average postoperative hospital stay was 5 days and the hospitalization cost was RMB $4,500～5,000. There were no complications such as pain, seroma, wound infection and recurrence. Conclusions TEP with epidural anesthesia, exempting the balloon dissector and non-stapling of the domestic polypropylene mesh is feasible. It is possible to be applied in hospitals at local level.