Rankin Adeline, Kostusiak Milo, Sokker Ashraf
Department of General Surgery, The Queen Elizabeth Hospital King's Lynn NHS Trust, King's Lynn, Norfolk, UK.
Visc Med. 2019 Apr;35(2):133-136. doi: 10.1159/000494280. Epub 2018 Oct 30.
Spigelian hernia (SH) is an uncommon ventral abdominal hernia. Traditionally repaired with an open technique, the laparoscopic approach is becoming more common and widely described in the literature. We hold that the transabdominal preperitoneal (TAPP) approach restores the anatomy and prevents complications such as seroma. We present a series of SH repair carried out at a single district general hospital over the past 13 years and a review of the literature.
A retrospective case note review identified SH repaired between January 2005 and March 2018 at The Queen Elizabeth Hospital, King's Lynn, Norfolk, UK. A Medline search for 'Spigelian hernia' and 'laparoscopic' revealed 41 papers for review.
33 patients underwent repair of SH. We found that the TAPP repair with a mesh is anatomically the most sound repair, with all the added benefits of keyhole surgery, i.e. reduced hospital stay, quicker recovery, and fewer infections. Our complication rates matched those described in the literature.
Several operative techniques have been described to repair SH. We favour the laparoscopic TAPP approach which is safe, aids in confirming the correct diagnosis, and has all the benefits of keyhole surgery.
半月线疝（SH）是一种少见的腹前壁疝。传统上采用开放技术修复，腹腔镜手术方法在文献中描述得越来越多且更为常见。我们认为经腹腹膜前（TAPP）手术方法能恢复解剖结构并预防诸如血清肿等并发症。我们呈现了过去13年在一家地区综合医院进行的一系列半月线疝修复手术以及文献综述。
通过回顾性病例记录审查确定了2005年1月至2018年3月在英国诺福克郡金斯林伊丽莎白女王医院接受修复的半月线疝患者。在医学文献数据库（Medline）中搜索“半月线疝”和“腹腔镜”，共检索到41篇论文以供综述。
33例患者接受了半月线疝修复手术。我们发现使用补片的TAPP修复术在解剖学上是最合理的修复方法，具有微创手术的所有额外益处，即住院时间缩短、恢复更快且感染更少。我们的并发症发生率与文献中描述的相符。
已经描述了几种修复半月线疝的手术技术。我们支持腹腔镜TAPP手术方法，该方法安全，有助于确诊，并且具有微创手术的所有优点。
