Ertem Metin, Ozben Volkan, Gok Hakan, Ozveri Emel
Department of General Surgery, Istanbul University, Cerrahpasa Medical Faculty, Cerrahpasa, Fatih, 34098 Istanbul, Turkey ; General Surgery Clinic, Kozyatagi Acibadem Hospital, 34742 Istanbul, Turkey.
General Surgery Clinic, Kozyatagi Acibadem Hospital, 34742 Istanbul, Turkey.
Minim Invasive Surg. 2013;2013:260131. doi: 10.1155/2013/260131. Epub 2013 Nov 28.
Background. Relaparoscopic treatment of inguinal hernia recurrences has become a relatively new concept with favourable results. The purpose of this study was to examine a series of relaparoscopic repair, present technical experiences, and the clinical outcomes in this subset of patients. Patients and Methods. The medical records of five patients who underwent relaparoscopic repair (TAPP or TEP) for a recurrence between March 2005 and September 2012 were retrospectively reviewed. Results. All the patients were male with a mean age of 45 years. Technical failures in the previous repairs were the main factors contributing to recurrences. In two re-TEP cases with no previous mesh fixation, the old mesh remained on the peritoneal side during preperitoneal dissection and this greatly facilitated surgical manipulation. The mean operative time was 93 min (range, 45-120 min). There were no conversions, no intraoperative complications, and no morbidity or rerecurrence after a mean follow-up period of 17 months (range, 7-24 months). Conclusion. Relaparoscopic repair appears to be safe and effective in the treatment of recurrent inguinal hernia and repeated TEP could be a simpler approach than expected in the presence of no prior mesh fixation.
背景。腹腔镜再次治疗腹股沟疝复发已成为一个相对较新的概念，且效果良好。本研究的目的是探讨一系列腹腔镜再次修补术，介绍该类患者的技术经验及临床结果。
患者与方法。回顾性分析2005年3月至2012年9月间5例行腹腔镜再次修补术（经腹腔腹膜前修补术或全腹膜外修补术）治疗腹股沟疝复发患者的病历资料。
结果。所有患者均为男性，平均年龄45岁。既往修补术的技术失败是导致复发的主要因素。在2例既往未固定补片的再次全腹膜外修补术中，腹膜前分离时旧补片仍留在腹膜侧，这极大地方便了手术操作。平均手术时间为93分钟（范围45 - 120分钟）。无中转开腹，无术中并发症，平均随访17个月（范围7 - 24个月）后无发病或复发。
结论。腹腔镜再次修补术治疗复发性腹股沟疝似乎安全有效，且在既往未固定补片的情况下，再次行全腹膜外修补术可能比预期更简单。
