Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Mail Stop BCM390, Houston, TX 77030, USA.
Hernia. 2011 Apr;15(2):225-7. doi: 10.1007/s10029-010-0638-3. Epub 2010 Feb 18.
Laparoscopic techniques for the repair of inguinal hernias have become an increasingly popular alternative to open techniques. No clear consensus has emerged as to the best laparoscopic technique, but the body of evidence increasingly favors a total extraperitoneal (TEP) approach.
We report the case of an adult man with an incarcerated right indirect inguinal sliding hernia involving the first known instance of a retroperitoneal ileum, and the novel use of a laparoscopic combined TEP approach and transabdominal preperitoneal (TAPP) approach to repair his hernia without complications. The literature is reviewed and TEP and TAPP techniques for the treatment of inguinal hernias are discussed and compared.
When faced with an unforeseen anomaly during herniorrhaphy in which improved abdominal visualization is necessary, a surgeon may convert from a TEP to a transabdominal laparoscopic approach safely and effectively.
腹腔镜技术已成为修复腹股沟疝的一种越来越受欢迎的替代开放技术。目前尚不清楚哪种腹腔镜技术是最好的，但越来越多的证据支持完全腹膜外（TEP）方法。
我们报告了一例成年男性右侧腹股沟滑动嵌顿疝的病例，这是首例已知的腹膜后回肠疝，我们创新性地使用腹腔镜联合 TEP 入路和经腹腹膜前（TAPP）入路修复其疝，无并发症。我们回顾了文献，并讨论和比较了 TEP 和 TAPP 技术在治疗腹股沟疝中的应用。
当在疝修补术中遇到需要改善腹部可视化的意外异常时，外科医生可以安全有效地从 TEP 转为经腹腹腔镜入路。
