目的 探讨Ultrapro轻量型网片在腹腔镜腹股沟疝修补术中的优点和应用价值。方法 回顾性总结分析我院2008年8月至2010年10月期间,腹腔镜腹股沟疝修补术中应用Ultrapro轻量型网片的28例患者的临床资料。结果 28例患者共行疝修补术36例次,其中实施经腹腹膜前腹腔镜疝修补术(TAPP) 9例次,腹腔镜全腹膜外疝修补术(TEP)27例次;1例TEP中转行TAPP。平均手术时间为(103.4±39.8) min,术中平均出血量为(7.7±4.9) ml,术后平均住院时间(4.8±1.4) d。术后修补区暂时性神经异常1例,阴囊积液2例,尿潴留1例。28例均随访(15±1.6)个月(1~25个月),期间未观察到网片感染、疝复发、慢性疼痛、异物感或睾丸萎缩等并发症。结论 Ultrapro轻量型网片在腹腔镜腹股沟疝修补术中应用方便、视野清晰、柔软、硬度适中、放置定位容易,术后患者并发症少、恢复快,具有较好的临床应用价值。
Objective To explore the important role of preperitoneal space in laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) hernia repair. Methods The clinical data of 66 patients (78 sides) performed laparoscopic TAPP and TEP hernia repair from January 2008 to April 2011 in this hospital were analyzed retrospectively. Results TAPP hernia repair were performed in 16 cases (20 sides),TEP hernia repair were performed in 50 cases (58 sides). Three cases of TEP hernia repair transferred to TAPP hernia repair. The unilateral operation time was (86.92±36.38) min,intraoperative bleeding was (6.08±3.43) ml. Postoperative complication rate was 16.7% (11/66),including 3 cases of postoperative serum swelling,3 cases of temporary paraesthesia of nerve feeling in the repair area,2 cases of scrotum emphysema,2 cases of urinary retention,and 1 case of intestinal obstruction. There were 2 cases of recurrence. The hospital stay was (4.52±0.99) d. The return to activities and working time was (10.32±1.86) d after discharge. Sixty-six cases were followed up for (18.56±1.96) months (range 1-38 months),the patch infection,chronic pain,and testicular atrophy complications were not been observed. Conclusions Acquainting and mastering laparoscopic preperitoneal space and its important structure are the key to avoid intraoperative and postoperative complications of laparoscopic inguinal hernia repair.