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经皮腹腔镜 TAPP 网片修补术:一种不断发展的技术。

Single-incision laparoscopic TAPP mesh hernioplasty using conventional instruments: an evolving technique.

机构信息

Department of General and Minimally Invasive Surgery, Asian Institute of Medical Sciences, Faridabad, India.

出版信息

Langenbecks Arch Surg. 2010 Nov;395(8):1157-60. doi: 10.1007/s00423-010-0656-8. Epub 2010 Jun 4.

Abstract

OBJECTIVE

The aim of this pilot study is to assess the safety, feasibility, and short-term outcomes of single-incision laparoscopic trans-abdominal preperitoneal (TAPP) mesh hernioplasty using conventional laparoscopic instruments.

METHODS

During a 3-month study period, data from all consecutive patients referred for inguinal hernia repair to the general and minimally invasive surgery unit of our institution who agreed to undergo single-incision TAPP mesh hernioplasty were included in the prospective study. Outcome measures included completion rate of the attempted procedure, operative time, length of hospital stay, postoperative pain, and assessment of complications. Follow-up was done for 3 months.

RESULT

Fifteen patients completed our protocol. Two patients had bilateral inguinal hernias while all other patients had unilateral hernia. Two patients had sliding hernia on the left side which had sigmoid colon as content. None of the patients required any additional port. There were no intraoperative complications.

CONCLUSIONS

The concept of laparoscopic single-incision surgery is an attractive and understandable innovation as laparoscopic surgery has become more commonplace. Based on our experience, we believe that the procedure is feasible without additional risk. Cosmetic benefit is clear; however, beyond the actual outcome with respect to postoperative pain and long-term complications, needs to be evaluated and compared to standard laparoscopic TAPP mesh hernioplasty.

摘要

目的

本初步研究旨在评估使用传统腹腔镜器械行单切口经腹腹膜前(TAPP)网片修补术的安全性、可行性和短期结果。

方法

在为期 3 个月的研究期间,将我院普外科和微创外科所有连续转介行腹股沟疝修补术并同意行单切口 TAPP 网片修补术的患者纳入前瞻性研究。观察指标包括完成尝试手术的比例、手术时间、住院时间、术后疼痛和并发症评估。随访 3 个月。

结果

15 名患者完成了我们的方案。2 名患者患有双侧腹股沟疝,而所有其他患者均患有单侧疝。2 名患者左侧有滑动疝,内容物为乙状结肠。没有患者需要额外的端口。术中无并发症。

结论

随着腹腔镜手术的普及,腹腔镜单切口手术的概念是一种有吸引力和易于理解的创新。根据我们的经验,我们认为该手术是可行的,没有额外的风险。美容效果明显;然而,除了术后疼痛和长期并发症的实际结果外,还需要对其进行评估并与标准腹腔镜 TAPP 网片修补术进行比较。

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