经腹腔镜腹膜前疝修补改良内缝合补片固定术

目的 探讨经腹腔镜腹膜前疝修补改良内缝合补片固定术临床应用的可行性。方法本院从2003年1月至2008年1月间对162例腹股沟疝患者实施腹腔镜疝修补内缝合固定术。其中单侧腹股沟斜疝134例（其中1例为嵌顿性），双侧腹股沟斜疝14例，腹股沟直疝12例。一侧为腹股沟斜疝而另一侧为腹股沟直疝2例。结果平均手术时间30min，术中、术后无并发症发生，术后2～3d出院。全部患者均获随访5～60个月，1例术后半年复发，无术后肠粘连、肠梗阻及术后顽固性神经痛等并发症发生。结论腹腔镜腹膜前疝修补改良内缝合补网固定术是集开放式无张力腹股沟疝修补术及TAPP（transabdominal preperitoneal）、IPOM（intraperitoneal onlay mesh）、TEP（totally extraperitoneal）的优点、弥补各自缺点为一体的可行性术式，其简便、易行、易推广。

An ameliorating repair methed of hernia with transabdominal preperitoneal internal sutrue fixation with mesh under peritoneoscope

Objective To discuss the feasibility of an ameliorating repair methed of hernia with transabdominal preperitoneal internal sutrue fixation with mesh under peritoneoscope in clinical practice. Methods 162 cases of inguinal hernia was operated with this new methed in our hospital from Jan 2003 to Jan 2008 ,including 134 cases with lateral indirect hernia（ one case was incarcerated hernia） , 14 cases with bilateral indirect hernia , 12 cases with direct hernia, and 2 cases with a indirect hernia on one side while a direct hernia on another side. Results The mean operation time is 30 minutes. No complications occured in operating time and after operation. The patients leave hospital after 2 to 3 days. All patients were followed-up from 5 to 60 months , there were no complications such as intestinal adhesion , ileus and obstinate neuralgia except one example recrudesced after half a year, Conclusions The new skill is feasibility that has the merit of open operation of no tension inguinal hernia repair, TAPP, IPOM, and TEP, it＇s also a reparation for their shortcomings . The methed is simple , easy and convenient to be popularized.