Karim Muhammad Ali, Ali Abdulmajid
Department of Surgery, University Hospital Ayr, Ayr, UK.
Asian J Endosc Surg. 2013 May;6(2):137-9. doi: 10.1111/ases.12002.
The redundant skin left behind after laparoscopic ventral hernia repair overlies a dead space that is a potential site for seroma formation. This predisposes patients to surgical-site infection and compromises the cosmetic outcome of the procedure, which is a key feature of the minimally invasive approach. We present a simple technique to deal with this problem.
This technique was used in six patients who underwent laparoscopic ventral hernia repair. Two patients were men and four were women. At the end of the procedure, glue (fibrin sealant) was injected in the dead space underneath the redundant skin and pressure was applied for some time; this attached the excessive skin to the underlying tissue. This obliterated the potential dead space, reducing the chances of seroma formation, and improved the cosmetic outcome of the procedure. Patients were reviewed 8 weeks after the procedure, and their body contours had returned to normal, with no skin redundancy.
Minimally invasive surgery offers the advantage of a shorter hospital stay, faster recovery and improved cosmetic outcome, achieving better patient satisfaction as a result. This simple technique at the end of laparoscopic ventral hernia repair, in which the redundant skin is attached to the underlying tissue, improves the immediate postoperative cosmetic outcome and also obliterates any potential dead space for seroma formation.
腹腔镜腹疝修补术后遗留的多余皮肤覆盖着一个潜在的死腔，这是血清肿形成的潜在部位。这使患者易发生手术部位感染，并影响手术的美容效果，而美容效果是微创方法的一个关键特征。我们介绍一种处理该问题的简单技术。
该技术应用于6例行腹腔镜腹疝修补术的患者。2例为男性，4例为女性。手术结束时，将胶水（纤维蛋白密封剂）注入多余皮肤下方的死腔，并施加一段时间的压力；这使多余的皮肤与下方组织粘连。这消除了潜在的死腔，减少了血清肿形成的机会，并改善了手术的美容效果。术后8周对患者进行复查，其身体轮廓已恢复正常，无皮肤冗余。
微创手术具有住院时间短、恢复快和美容效果改善的优点，从而实现了更高的患者满意度。这种在腹腔镜腹疝修补术结束时采用的简单技术，即将多余皮肤与下方组织粘连，改善了术后即刻的美容效果，也消除了血清肿形成的任何潜在死腔。
