Department of Hernia and Abdominal Wall Surgery, Shanghai East Hospital, Tongji University, Shanghai, China.
Minim Invasive Ther Allied Technol. 2022 Feb;31(2):262-268. doi: 10.1080/13645706.2020.1780452. Epub 2020 Jul 17.
Using self-gripping mesh eliminates the need for additional mechanical fixation in laparoscopic groin hernia repair when surgeons plan to fix it. However, the mesh's 'self-gripping' characteristic makes it much more difficult to unfold and place. Here, the novel "Swiss-roll" placement method of folding self-gripping mesh is introduced and compared to the common folding placement method.
The cohort of this prospective randomized controlled study included 100 patients who underwent transabdominal preperitoneal (TAPP) groin hernia repair in the Department of Hernia and Abdominal Wall Surgery of Shanghai East Hospital between January and December 2018. The patients were randomly assigned to the "Swiss-roll" folding group or the common folding group. The time required for mesh placement, total surgical duration, and the incidences of postoperative pain and complications were compared.
The times required for mesh placement in the "Swiss-roll" and common folding groups were 155.10 ± 48.66 and 202.80 ± 61.05 sec, respectively. The "Swiss-roll" folding method significantly shortened the time required for mesh placement ( = 0.000). There were no significant differences in total surgical duration and the incidences of postoperative pain and complications between the two groups.
The "Swiss-roll" folding method facilitates self-gripping mesh placement without increasing the incidence of complications and recurrences in TAPP.
在腹腔镜腹股沟疝修补术中，如果外科医生计划固定网片，则使用自固定网片可消除对额外机械固定的需求。然而，网片的“自固定”特性使其展开和放置变得更加困难。此处介绍了一种折叠自固定网片的新型“瑞士卷”放置方法，并与常规折叠放置方法进行了比较。
本前瞻性随机对照研究的队列纳入了 2018 年 1 月至 12 月期间在上海东方医院疝与腹壁外科接受经腹腹膜前（TAPP）腹股沟疝修补术的 100 例患者。患者被随机分配至“瑞士卷”折叠组或常规折叠组。比较两组网片放置时间、总手术时间以及术后疼痛和并发症的发生率。
“瑞士卷”和常规折叠组的网片放置时间分别为 155.10±48.66 秒和 202.80±61.05 秒。“瑞士卷”折叠法显著缩短了网片放置时间（ = 0.000）。两组的总手术时间以及术后疼痛和并发症的发生率均无显著差异。
“瑞士卷”折叠法有利于自固定网片的放置，而不会增加 TAPP 术后并发症和复发的发生率。
