Guzmán-Valdivia G, Medina O, Martínez A
Department of General Surgery of General Hospital No 1, Gabriel Mancera Mexican Institute of Social Security, Mexico City, Mexico.
Hernia. 2003 Dec;7(4):206-9. doi: 10.1007/s10029-003-0150-0. Epub 2003 Sep 16.
This paper describes a simplified technique for the repair of incisional hernias. The previous scar is resected, and the peritoneal sac is carefully dissected until it is completely exposed. The sac is opened to liberate structures adherent to the sac or to the area immediately surrounding the defect. The peritoneum is closed and invaginated to form a sac bed underlying the entire extent of the defect, and the mesh is laid on this sac bed. The mesh is then fixed with "U" stitches, reinforcing these by inserting a second line from the edge of the defect to the mesh. Suture material used is polypropylene 1/0 or 2/0. This procedure has been carried out on 15 patients, and after 1 year of follow-up, there has been no recurrence of the hernia. Operating time was reduced, and the surgical technique was found to be easier. Placing a mesh prosthesis inside the hernia sac and fixing it to the abdominal wall with two lines of suturing simplifies the repair procedure, reduces operating time, and is effective in the repair of all incisional hernias. A study is required to compare this outcome with the different mesh repair techniques.
本文介绍了一种修复切口疝的简化技术。切除先前的瘢痕,仔细解剖腹膜囊直至其完全暴露。打开囊以松解与囊或缺损紧邻区域粘连的结构。关闭腹膜并使其内陷以在缺损的整个范围内形成囊床,然后将补片放置在该囊床上。然后用“U”形缝线固定补片,并从缺损边缘向补片插入第二条线以加强固定。使用的缝合材料为聚丙烯1/0或2/0。该手术已在15例患者中实施,随访1年后,疝无复发。手术时间缩短,且发现手术技术更简便。将补片假体置于疝囊内并用两行缝合固定于腹壁,简化了修复程序,缩短了手术时间,对所有切口疝的修复均有效。需要进行一项研究以将该结果与不同的补片修复技术进行比较。