Li B G, Gong D H, Miao J C, Nie X Y, Qin C F
Department of General Surgery, Affiliated Hexian Memorial Hospital of Southern Medical University, Guangzhou 511400, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 25;98(36):2933-2936. doi: 10.3760/cma.j.issn.0376-2491.2018.36.012.
Investigating a novel approach to treat a midline ventral hernia--totally endoscopic sublay repair (TES). The procedure will be described in detail and the safety and efficacy evaluated. During July and December 2017, eleven consecutive cases of primary and secondary epigastric midline ventral hernias were repaired using the TES procedure. A large mesh should be placed in the retrorectus position using this minimally invasive procedure. The indications for this procedure include umbilical, epigastric and incisional hernia equal in length to the rectus diastasis. All operations were successful without open conversion. The mean operation time was 120 mins(80-205 min), postoperative pain was mild and the mean VAS was 2.5 on first postoperative day. The average postoperative stay in hospital was 3.3 days (2-5 days). 2 cases experienced postoperative seroma but without adverse effect on the final outcome and no recurrences during the follow-up period of 1 to 6 months. TES procedure is safe, practical and minimally invasive requiring no specific device and highly reproducible. Besides there is no need for expensive anti-adhesion mesh and fixation tacker which make it more cost effective. TES is a good technique for the surgical treatment of midline ventral hernia.
探索一种治疗中线腹疝的新方法——完全内镜下肌后修补术（TES）。将详细描述该手术过程，并评估其安全性和有效性。在2017年7月至12月期间，连续11例原发性和继发性上腹中线腹疝患者接受了TES手术修补。采用这种微创手术应在腹直肌后间隙放置一块大补片。该手术的适应证包括脐疝、上腹疝和切口疝，其长度与腹直肌分离程度相等。所有手术均成功，未中转开放手术。平均手术时间为120分钟（80 - 205分钟），术后疼痛轻微，术后第一天平均视觉模拟评分（VAS）为2.5。术后平均住院时间为3.3天（2 - 5天）。2例患者术后出现血清肿，但对最终结局无不良影响，在1至6个月的随访期内无复发。TES手术安全、实用且微创，无需特殊设备，可重复性高。此外，无需使用昂贵的防粘连补片和固定钉，使其更具成本效益。TES是治疗中线腹疝的一种良好手术技术。
