Olmi Stefano, Cesana Giovanni, Sagutti Luca, Pagano Claudio, Vittoria Giuseppe, Croce Enrico
San Giuseppe Hospital, General Surgery II, Laparoscopic and Mini-Invasive Surgery Centre, Via San Vittore 12, 20123 Milano, Italy.
JSLS. 2010 Apr-Jun;14(2):240-5. doi: 10.4293/108680810X12785289144359.
Laparoscopic treatment of incisional hernias can be performed using different types of fixation devices and prosthesis. We present a case series of 19 patients with incisional hernias with a diameter of < 6 cm, who underwent laparoscopic repair using Hi-tex dual-side mesh, positioned intraperitoneally, fixed to the abdominal wall by fibrin glue (Tissucol).
Nineteen patients with incisional hernias < 6 cm in diameter were enrolled in this study and treated laparoscopically with Hi-tex and Tissucol. Surgical complications and patient outcomes were assessed with a clinical follow-up.
Laparoscopic repair of incisional hernias by using Hi-tex mesh affixed to the parietal wall with fibrin glue was feasible and easy in patients with parietal defects < 6 cm in diameter. Mean operating time was 30 minutes. Mean hospital stay was 1.5 days. Almost no postoperative pain, major surgical complications, seroma formation, relapses, or prosthesis infection occurred during a mean follow-up of 20 months.
In select patients, Hi-tex mesh affixed using fibrin glue allows laparoscopic repair of incisional hernias with very good patient outcomes, especially in terms of postoperative pain and seroma formation.
腹腔镜下治疗切口疝可使用不同类型的固定装置和假体。我们报告了一组19例直径小于6 cm的切口疝患者的病例系列,这些患者接受了腹腔镜修补术,使用Hi-tex双侧补片,置于腹腔内,并用纤维蛋白胶(Tissucol)固定于腹壁。
19例直径小于6 cm的切口疝患者纳入本研究,采用Hi-tex和Tissucol进行腹腔镜治疗。通过临床随访评估手术并发症和患者预后。
对于直径小于6 cm的腹壁缺损患者,使用纤维蛋白胶将Hi-tex补片固定于腹壁的腹腔镜修补术可行且简便。平均手术时间为30分钟。平均住院时间为1.5天。在平均20个月的随访期间,几乎未发生术后疼痛、严重手术并发症、血清肿形成、复发或假体感染。
在特定患者中,使用纤维蛋白胶固定Hi-tex补片可使腹腔镜下切口疝修补术获得非常好的患者预后,尤其是在术后疼痛和血清肿形成方面。