Misra M C, Bansal V K, Kumar S, Prashant B, Bhattacharjee H K
Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Hernia. 2008 Feb;12(1):65-71. doi: 10.1007/s10029-007-0281-9. Epub 2007 Sep 9.
The laparoscopic repair of groin hernia is increasingly being used. However, the relative merits and demerits of laparoscopic repair are debatable. The present study was undertaken to evaluate the total extra-peritoneal (TEP) repair of groin hernia.
This prospective study was undertaken at a single surgical unit between January 2004 and June 2006. Consecutive patients with elective groin hernias were offered laparoscopic TEP repair. Indigenous balloon or telescopic dissection was used to create extra-peritoneal space. Polypropylene mesh was used in all of the patients and mesh fixation was performed with tackers.
A total of 185 patients with age range 18-92 years were included; 180 were males. TEP repair was attempted in 298 groin hernias in 185 patients with a success rate of 89.5%. Indigenous balloon or telescopic dissection was used to create extra-peritoneal space. Thirty-one (31, 10.5%) TEP repairs were converted to transabdominal pre-peritoneal or open repair. Two patients developed recurrence during follow-up.
TEP is an excellent technique for laparoscopic groin hernia repair, with acceptable rates of complication.
腹股沟疝的腹腔镜修补术应用日益广泛。然而,腹腔镜修补术的相对优缺点仍存在争议。本研究旨在评估腹股沟疝的完全腹膜外(TEP)修补术。
本前瞻性研究于2004年1月至2006年6月在单一外科单位进行。连续入选择期腹股沟疝患者,接受腹腔镜TEP修补术。采用国产球囊或套管扩张法建立腹膜外间隙。所有患者均使用聚丙烯补片,并用钉合器固定补片。
共纳入185例年龄在18 - 92岁的患者,其中180例为男性。对185例患者的298例腹股沟疝尝试进行TEP修补,成功率为89.5%。采用国产球囊或套管扩张法建立腹膜外间隙。31例(10.5%)TEP修补术转为经腹腹膜前修补术或开放修补术。2例患者在随访期间出现复发。
TEP是一种用于腹腔镜腹股沟疝修补的优秀技术,并发症发生率可接受。