Fine Arthur P
Department of Surgery, Jefferson Regional Medical Center, Pittsburgh, Pennsylvania, USA.
JSLS. 2006 Oct-Dec;10(4):461-5.
We tested the hypothesis that laparoscopic inguinal herniorrhaphy using Surgisis mesh secured with fibrin sealant is an effective long-term treatment for repair of inguinal hernia. This case series involved 38 adult patients with 51 inguinal hernias treated in a primary care center.
Between December 2002 and May 2005, 38 patients with 45 primary and 6 recurrent inguinal hernias were treated with laparoscopic repair by the total extraperitoneal mesh placement (TEP) technique using Surgisis mesh secured into place with fibrin sealant. Postoperative complications, incidence of pain, and recurrence were recorded, as evaluated at 2 weeks, 6 weeks, 1 year, and with a follow-up questionnaire and telephone interview conducted in May and June 2005.
The operations were successfully performed on all patients with no complications or revisions to an open procedure. Average follow-up was 13 months (range, 1 to 30). One hernia recurred (second recurrence of unilateral direct hernia), indicating a 2% recurrence rate.
Laparoscopic repair of inguinal hernia using Surgisis mesh secured with fibrin sealant can be effectively used to treat primary, recurrent, direct, indirect, and bilateral inguinal hernias in adults without complications and minimal recurrence within 1-year of follow-up.
我们检验了如下假设,即使用纤维蛋白密封剂固定的Surgisis补片进行腹腔镜腹股沟疝修补术是腹股沟疝修补的一种有效的长期治疗方法。本病例系列纳入了在一家初级保健中心接受治疗的38例成年患者,共51例腹股沟疝。
在2002年12月至2005年5月期间,对38例患者(45例原发性和6例复发性腹股沟疝)采用完全腹膜外补片植入(TEP)技术进行腹腔镜修补,使用纤维蛋白密封剂将Surgisis补片固定到位。记录术后并发症、疼痛发生率和复发情况,评估时间点为术后2周、6周、1年,并于2005年5月和6月通过随访问卷和电话访谈进行。
所有患者手术均成功完成,无并发症,也未转为开放手术。平均随访时间为13个月(范围1至30个月)。1例疝复发(单侧直疝第二次复发),复发率为2%。
使用纤维蛋白密封剂固定的Surgisis补片进行腹腔镜腹股沟疝修补术可有效用于治疗成人原发性、复发性、直疝、斜疝和双侧腹股沟疝,无并发症,且随访1年内复发率极低。