Shih Tune-Yie, Wen Kuo-Chang, Lin Kai-Yuan, Uen Yih-Huei
Division of General Surgery, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan.
J Laparoendosc Adv Surg Tech A. 2012 Mar;22(2):162-4. doi: 10.1089/lap.2011.0235. Epub 2011 Dec 6.
To assess the feasibility, safety, and short-term outcome of a transumbilical, single-port, totally extraperitoneal (TEP) laparoscopic inguinal hernia repair, using a homemade port and a conventional instrument.
Thirty consecutive patients with inguinal hernias (including 20% with bilateral inguinal hernias) underwent a transumbilical, single-port, TEP laparoscopic hernia (LH) repair using a homemade port composed of a segment of corrugated anesthesia tube and a pair of surgical gloves. All operation procedures were done using conventional laparoscopic instruments with manually angled shafts in the same manner as standard multiple-port surgeries, but using the reverse hand technique.
All the procedures were completed uneventfully and did not require additional ports. Operation times averaged 98.3 ± 26.7 minutes for the unilateral LH and 121.4 ± 13.5 minutes for the bilateral LH. There were no perioperative complications except for 2 patients (7%) who developed wound seromas, which resolved after conservative treatment. No hernia recurred during the 6-month follow-up.
A transumbilical, single-port, TEP laparoscopic hernioplasty using a homemade port and a conventional instrument permitted nearly scarless surgery for the treatment of inguinal hernias. Further studies are necessary before this approach can be recommended as a standard procedure.
评估使用自制端口和传统器械经脐单孔完全腹膜外（TEP）腹腔镜腹股沟疝修补术的可行性、安全性及短期疗效。
连续30例腹股沟疝患者（包括20%双侧腹股沟疝患者）接受了经脐单孔TEP腹腔镜疝修补术，使用由一段波纹状麻醉管和一副手术手套组成的自制端口。所有手术操作均使用传统的腹腔镜器械，其轴可手动弯曲，操作方式与标准多孔手术相同，但采用反手法技术。
所有手术均顺利完成，无需额外端口。单侧腹腔镜疝修补术平均手术时间为98.3±26.7分钟，双侧腹腔镜疝修补术平均手术时间为121.4±13.5分钟。除2例患者（7%）出现伤口血清肿，经保守治疗后消退外，无围手术期并发症。6个月随访期间无疝复发。
使用自制端口和传统器械的经脐单孔TEP腹腔镜疝修补术可实现腹股沟疝的近乎无痕手术。在该方法被推荐为标准手术之前，还需要进一步研究。
