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杜吕克腹腔镜完全腹膜外疝修补术

Dulucq's technique for laparoscopic totally extraperitoneal hernioplasty.

作者信息

Agrawal Mohit, Bhagwat Sonali, Rao Prashanth

机构信息

Department of Surgery, Sanjeevani Hospital, Global Hospitals, Mumbai, Maharashtra, India.

Department of GI and Minimal Access Surgery, Global Hospitals, Mumbai, Maharashtra, India.

出版信息

J Minim Access Surg. 2020 Jan-Mar;16(1):94-96. doi: 10.4103/jmas.JMAS_66_18.

DOI:10.4103/jmas.JMAS_66_18
PMID:30416144
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6945329/
Abstract

BACKGROUND

Inguinal hernia repair has been a controversial area in surgical practice. Its complexity is reflected by the fact that numerous different procedures including both open and laparoscopic techniques are in use today. Laparoscopic totally extraperitoneal (TEP) repair is preferred over transabdominal pre-peritoneal repair as the peritoneum is not breached and also due to fewer intra-abdominal complications. This is the most elegant technique but rather difficult to perform.

AIM

The purpose of this study was to describe Dulucq's technique for inguinal hernia repair and the use of three-dimensional mesh without fixation in laparoscopic TEP inguinal hernioplasty.

METHODS

Surgical technique of laparoscopic TEP inguinal hernia repair is detailed in the text.

RESULTS

A total of 945 hernia repairs were included in the study. The hernias were repaired by Dulucq's technique. Mean operative time was 45 min in unilateral hernia and 65 min in bilateral hernia. There were no serious complications.

CONCLUSION

The laparoscopic TEP hernioplasty by Dulucq's technique is feasible with fewer intra-abdominal complications. The dissection must always be done with the same stages with minimal monopolar diathermy and patient in a slight Trendelenburg position.

摘要

背景

腹股沟疝修补术一直是外科手术实践中的一个有争议的领域。其复杂性体现在如今有众多不同的手术方法，包括开放手术和腹腔镜技术都在使用。腹腔镜完全腹膜外（TEP）修补术优于经腹腹膜前修补术，因为它不破坏腹膜，且腹腔内并发症较少。这是最精巧的技术，但实施起来相当困难。

目的

本研究的目的是描述杜吕克（Dulucq）腹股沟疝修补术技术以及在腹腔镜TEP腹股沟疝修补术中使用无固定三维补片的情况。

方法

腹腔镜TEP腹股沟疝修补术的手术技术在文中详细描述。

结果

本研究共纳入945例疝修补术。疝采用杜吕克技术进行修补。单侧疝的平均手术时间为45分钟，双侧疝为65分钟。无严重并发症。

结论

采用杜吕克技术的腹腔镜TEP疝修补术可行，腹腔内并发症较少。解剖操作必须始终按照相同步骤进行，尽量减少单极电凝使用，患者取轻度头低脚高位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/939d85476411/JMAS-16-94-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/7051144007e7/JMAS-16-94-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/c46ae2b5a832/JMAS-16-94-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/e68755d6c3bb/JMAS-16-94-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/4edce5dfd73d/JMAS-16-94-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/d14364e9911e/JMAS-16-94-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/1fe3b7a98155/JMAS-16-94-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/939d85476411/JMAS-16-94-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/7051144007e7/JMAS-16-94-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/c46ae2b5a832/JMAS-16-94-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/e68755d6c3bb/JMAS-16-94-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/4edce5dfd73d/JMAS-16-94-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/d14364e9911e/JMAS-16-94-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/1fe3b7a98155/JMAS-16-94-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1b5/6945329/939d85476411/JMAS-16-94-g007.jpg

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