Department of General & Laparoscopic Surgery, Sir Ganga Ram Hospital, New Delhi, India.
Int J Surg. 2011;9(1):79-82. doi: 10.1016/j.ijsu.2010.08.010. Epub 2010 Oct 8.
Ventral hernia is a common surgical problem. The traditional open surgical repair has the disadvantage of excessive morbidity, long hospital stay and high recurrence rates. Laparoscopic ventral hernia repair (LVHR) is gaining acceptance but there is no standardized technique for the repair of these hernias. We have introduced an innovative technique of 2-port laparoscopic mesh repair for ventral and incisional hernias. Between January 2002 and September 2008, 168 patients underwent the 2-port repair of ventral hernias at our institution, with Bard polypropylene mesh in 162 cases and Gore-tex expanded polytetrafloroethylene mesh in 6 patients. The average size of the defects was 10.2 cm (6.6-24.8 cm). Mean operating time was 61.4 min (48-102 min). The mean post-operative hospital stay was 1.2 days. Prolonged ileus over one day occurred in 22 patients while 6 patients had urinary retention in the post-operative period. There were 6 recurrences (3.94%) in the mean follow up period of 42 months (6-62 months). Seroma formation occurred in 5.3% cases but all of them subsided within 6 weeks without any active intervention. In conclusion we recommend that the 2-port LVHR is a technically sound procedure which is less invasive and with comparable complication rates to the 3 or 4 port hernia repair.
腹壁疝是一种常见的外科问题。传统的开放式外科修补术存在发病率高、住院时间长和复发率高的缺点。腹腔镜腹壁疝修补术(LVHR)越来越被接受,但对于这些疝的修复还没有标准化的技术。我们引入了一种创新的 2 端口腹腔镜网片修补技术,用于治疗腹壁和切口疝。2002 年 1 月至 2008 年 9 月,我们机构对 168 例腹壁疝患者进行了 2 端口修补术,其中 162 例采用 Bard 聚丙烯网片,6 例采用 Gore-tex 膨体聚四氟乙烯网片。缺损的平均大小为 10.2cm(6.6-24.8cm)。平均手术时间为 61.4 分钟(48-102 分钟)。平均术后住院时间为 1.2 天。22 例患者出现 1 天以上的长时间肠梗阻,6 例患者在术后出现尿潴留。在平均 42 个月(6-62 个月)的随访中,有 6 例(3.94%)复发。5.3%的病例出现血清肿,但均在 6 周内自行消退,无需任何积极干预。总之,我们建议 2 端口 LVHR 是一种技术上可靠的方法,与 3 端口或 4 端口疝修补术相比,其侵袭性更小,并发症发生率相当。