Otsuka Shimpei, Kaneoka Yuji, Maeda Atsuyuki, Takayama Yuichi, Fukami Yasuyuki, Onoe Shunsuke
Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan.
Updates Surg. 2017 Mar;69(1):55-60. doi: 10.1007/s13304-016-0412-x. Epub 2016 Dec 23.
Laparoscopic transabdominal preperitoneal (TAPP) is gaining popularity as an approach to repairing of inguinal hernia. In many institutions, a disposable ultrasonic energy device is used in the TAPP repair procedure. However, the benefit and necessity of an ultrasonic device are unclear. We have switched to use of a reusable monopolar energy device, and we conducted a retrospective study comparing the surgical results obtained with each of the energy devices. Our study group comprised 241 adults who underwent TAPP repair for inguinal hernia between November 2012 and December 2014. We compared clinical characteristics, and surgical outcomes between patients in whom a disposable ultrasonic energy device was used (n = 116, U group) and those in whom a reusable monopolar energy device (n = 125, M group) was used. There was no statistically significant difference between the 2 groups in age, sex, body mass index, or hernia type. In cases of unilateral hernia, operation time was significantly longer in the U group than in the M group (71.4 vs. 59.4 min, respectively, p < 0.001). No significant difference was found in intraoperative blood loss (2.3 vs 3.9 ml, p = 0.329), postoperative morbidity (5.2 vs 4.0%, p = 0.663), or postoperative hospital stay (2.1 vs 2.2 days, p = 0.336). Our experience and increased competence with the monopolar energy device lead us to conclude that the ultrasonic energy device is unnecessary for simple TAPP repair.
腹腔镜经腹腹膜前修补术（TAPP）作为一种腹股沟疝修补方法正越来越受欢迎。在许多机构中，一次性超声能量设备被用于TAPP修补手术。然而，超声设备的益处和必要性尚不清楚。我们已改用可重复使用的单极能量设备，并进行了一项回顾性研究，比较了使用每种能量设备所获得的手术结果。我们的研究组包括241名在2012年11月至2014年12月期间接受腹股沟疝TAPP修补术的成年人。我们比较了使用一次性超声能量设备的患者（n = 116，U组）和使用可重复使用单极能量设备的患者（n = 125，M组）之间的临床特征和手术结果。两组在年龄、性别、体重指数或疝类型方面无统计学显著差异。在单侧疝病例中，U组的手术时间明显长于M组（分别为71.4分钟和59.4分钟，p < 0.001）。术中出血量（2.3毫升对3.9毫升，p = 0.329）、术后发病率（5.2%对4.0%，p = 0.663）或术后住院时间（2.1天对2.2天，p = 0.336）均未发现显著差异。我们使用单极能量设备的经验和能力的提高使我们得出结论，对于简单的TAPP修补，超声能量设备是不必要的。
