Holzinger F, Klaiber C
Klinik für Viszerale und Transplantationschirurgie, Universität Bern, Inselspital, Bern, Schweiz, Germany.
Chirurg. 2002 Sep;73(9):899-904. doi: 10.1007/s00104-002-0525-2.
With increasing numbers of laparoscopic procedures more postoperative trocar site hernias can be expected. This complication of minimally invasive surgery is rare but potentially dangerous. According to the literature, the overall incidence of trocar site hernias is expected to be around 1%. Among trocar site hernias, Richter's hernias are the most frequent, accounting for two-thirds of all small intestinal hernias. The following risk factors for the development of trocar site hernias have been identified: the trocar diameter, the trocar design, preexisting fascial defects, and some operation- and patient-related factors. Peritoneal and fascial closure should be done when blunt trocars of >10 mm have been employed. Based on the literature and our own experience, some preventive recommendations are given to further reduce the risk of hernia formation at trocar sites.
随着腹腔镜手术数量的增加，预计术后套管针穿刺部位疝的发生数量会更多。这种微创手术的并发症虽罕见但具有潜在危险性。根据文献，套管针穿刺部位疝的总体发生率预计约为1%。在套管针穿刺部位疝中，里脱氏疝最为常见，占所有小肠疝的三分之二。已确定以下套管针穿刺部位疝发生的危险因素：套管针直径、套管针设计、既往存在的筋膜缺损以及一些与手术和患者相关的因素。当使用直径大于10mm的钝性套管针时，应进行腹膜和筋膜闭合。基于文献和我们自己的经验，给出了一些预防性建议，以进一步降低套管针穿刺部位疝形成的风险。
