Department of General and Hepatobiliary Surgery and Liver Transplantation Service, Ghent University Hospital and Medical School, De Pintelaan 185 2K12-IC, 9000 Ghent, Belgium.
Hernia. 2013 Jun;17(3):365-71. doi: 10.1007/s10029-013-1110-y. Epub 2013 May 21.
To prospectively evaluate the use of a continuous Nitinol containing memory frame patch during a TIPP-technique in the open repair of inguinal and femoral hernias.
Over a 3-year period all consecutive adult patients that needed treatment for an inguinal or femoral hernia were treated by the TIPP repair using the Rebound Shield mesh. Intra-operatively the type and size of the hernia were evaluated according to the EHS classification, as well as the size of the mesh used. Baseline characteristics for all patients were evaluated considering age, gender, BMI and American society of Anesthesiologists score. Standard X-ray was performed to evaluate mesh position. All patients were evaluated for post-operative pain using the visual analogue scale (VAS 0-10 scale).
In total 289 groin hernias were operated using a nitinol containing patch in 235 patients. The mean operating time was 38 min for unilateral hernias and 59 min for bilateral hernias. The median follow-up is 21.2 months (14-33 months) during which three patients died, unrelated to the groin hernia repair. At the time of re-evaluation 12 patients (5.0 %) complained of chronic pain, with a VAS score higher than 3 after 3 months (range 3-10). Two of these patients already had severe pain pre-operatively. A total of 3 recurrences (2.9 %) were noted with strong correlation with X-ray findings.
A nitinol memory frame containing mesh is a valuable tool to achieve complete deployment of a large pore mesh in a TIPP repair for inguinal hernias with acceptable morbidity and a low recurrence rate.
前瞻性评估在开放式腹股沟和股疝修补术中使用连续含镍钛记忆框架补丁的效果。
在 3 年期间，所有需要接受腹股沟或股疝治疗的成年患者均采用 TIPP 修复技术和 Rebound Shield 网片进行治疗。术中根据 EHS 分类评估疝的类型和大小，以及使用的网片大小。评估所有患者的基线特征，包括年龄、性别、BMI 和美国麻醉医师协会评分。使用标准 X 射线评估网片位置。所有患者均使用视觉模拟评分（VAS 0-10 评分）评估术后疼痛。
共 235 例患者的 289 例腹股沟疝采用含镍钛记忆框架补丁进行手术。单侧疝的平均手术时间为 38 分钟，双侧疝为 59 分钟。中位随访时间为 21.2 个月（14-33 个月），在此期间有 3 例患者死亡，与腹股沟疝修补无关。在重新评估时，有 12 例患者（5.0%）抱怨慢性疼痛，3 个月后 VAS 评分高于 3（范围 3-10）。其中 2 例患者术前已有严重疼痛。共有 3 例（2.9%）复发，与 X 射线发现有很强的相关性。
含镍钛记忆框架的网片是一种有价值的工具，可以在 TIPP 修复术中实现大孔径网片的完全展开，用于腹股沟疝，具有可接受的发病率和较低的复发率。
