Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium.
Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium.
Int J Surg. 2017 Apr;40:139-144. doi: 10.1016/j.ijsu.2017.02.091. Epub 2017 Feb 28.
The use of a self-expanding nitinol framed prosthesis (ReboundHRD) for totally extraperitoneal laparoscopic inguinal hernia repair (TEP-IHR) could solve issues of mesh shrinkage and associated pain. We prospectively evaluated the use of the ReboundHRD mesh for TEP-IHR.
All patients who underwent a TEP-IHR using the ReboundHRD Large mesh from April 2014 till May 2015, were included. No mesh fixation was performed. Follow-up assessments were performed at the day of surgery, 1, 2, and 7 days, 1, 3, 6, and 12 months. Outcome measures include post-operative pain (visual analogue scale, VAS), operative details, complications, and recurrence rate.
In total, 69 TEP-IHR procedures were performed in 54 patients (15 bilateral hernias). No perioperative and 5 (9%) postoperative complications occurred, all graded Clavien-Dindo I-II. The median length of stay was 1 day (range 0-3), with 78% of the operations performed in an ambulatory setting. Median VAS score decreased from 3 (range 0-4) on the day of surgery to 1 (range 0-2) on day 7. Patients were completely pain-free at a median time of 5 (range 1-60) days. The majority (80.4%, 37/46) of the active patients went back to work within 2 weeks (maximum 6 weeks). At a median follow-up of 19 months (range 16-26 months), no recurrences occurred.
TEP-IHR using a self-expanding nitinol framed hernia repair device is a safe technique in longterm follow-up. The technique is associated with a low incidence of postoperative pain, a short hospital stay and quick return to normal activities.
使用自膨式镍钛诺框架假体（ReboundHRD）进行完全腹膜外腹腔镜腹股沟疝修补术（TEP-IHR）可以解决网片收缩和相关疼痛的问题。我们前瞻性地评估了 ReboundHRD 网片在 TEP-IHR 中的应用。
所有于 2014 年 4 月至 2015 年 5 月期间接受 TEP-IHR 且使用 ReboundHRD 大网片的患者均纳入研究。未进行网片固定。在手术当天、第 1、2 和 7 天、第 1、3、6 和 12 个月进行随访评估。评估指标包括术后疼痛（视觉模拟评分，VAS）、手术细节、并发症和复发率。
共有 54 例患者（15 例双侧疝）共 69 例接受了 TEP-IHR 手术，无围手术期和 5 例（9%）术后并发症发生，均为 Clavien-Dindo I-II 级。中位住院时间为 1 天（范围 0-3 天），78%的手术在日间病房完成。VAS 评分中位数从手术当天的 3 分（范围 0-4 分）降至第 7 天的 1 分（范围 0-2 分）。患者在中位时间 5 天（范围 1-60 天）内完全无痛。大多数（80.4%，37/46）活动患者在 2 周内（最长 6 周）恢复工作。在中位随访 19 个月（范围 16-26 个月）时，无复发。
在长期随访中，使用自膨式镍钛诺框架疝修补装置的 TEP-IHR 是一种安全的技术。该技术与术后疼痛发生率低、住院时间短和快速恢复正常活动相关。
