腹腔镜下腹壁切口疝修补术(附41例报告)

目的探讨腹腔镜下采用聚丙烯和膨化聚四氟乙烯复合补片（Bard Composix Mesh）修补腹壁切口疝的效果。方法2004年10月～2005年8月，对41例切口疝（腹壁缺损长径3～25cm，宽径3～18cm）腹腔镜下用超声刀进行腹腔内粘连松解和采用强生疝修补用缝合器行补片固定修补术。结果41例均顺利完成，无中转开腹。手术时间60～182min，平均85min。术后疼痛轻微，术后排便、排气时间25～41h，平均32h。术后第2天进食。术后住院5～7d，平均6d。41例随访6～16个月，平均9个月，未见切口疝复发。结论腹腔镜下采用复合补片修补腹壁切口疝是一种安全、有效的方法，值得临床推广应用。

Laparoscopic repair of abdominal wall incisional hernia: A report of 41 cases

Objective To investigate effects of laparoscopic repair of abdominal wall incisional hernia using polypropylene and expanded polytetrafluoroethylene(e-PTFE) composite mesh. Methods Forty-one patients with abdominal wall incisional hernia(4~25 cm in length and 3~18 cm in width) were treated in this hospital from October 2004 to August 2005. The patients received laparoscopic mesh herniorrhaphy after complete dissection of adhesion using an ultrasonic scalpel.A polypropylene and(e-PTFE) composite mesh(Bard Composite Mesh) was used and fixed using the Ethicon Endopath Multifeed Stapler(EMS).Results The laparoscopic mesh herniorrhaphy was successfully completed in all the 41 patients without conversions to open surgery.The operative time was 60~182 min(mean,85 min).Postoperatively,the patients felt slight pain and began to take food on the second day.The time to first passing flatus was 25~41 hours(mean,32 hours).The postoperative hospital stay was 5~7 days(mean,6 days).No recurrence occurred during a follow-up period of 6~16 months(mean,9 months) in the 41 patients. Conclusions The laparoscopic incisional hernia repair using the Bard Composite Mesh is a safe and effective method.