Caruso Riccardo, Vicente Emilio, Quijano Yolanda, D'Ovidio Angelo, Ielpo Benedetto, Ferri Valentina
Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, Madrid, Spain.
Int J Surg Case Rep. 2020;76:549-551. doi: 10.1016/j.ijscr.2020.10.063. Epub 2020 Oct 20.
Giant inguinoscrotal (GIS) hernias are rarely encountered in clinical settings and are often associated with mental neglect for many years. This type of hernia is defined as "giant" if it descends below the mid-point of the inner thigh of a patient in an upright position. The laparoscopic repair approach of a GIS hernia is technically challenging. It has been claimed that laparoscopic surgery has several advantages over the open surgical approach, with less pain and an earlier recovery. The aim of this video is to evaluate the efficacy of TAPP (laparoscopic transabdominal preperitoneal) in order to treat a GIS hernia.
A 65-year-old male without a relevant past medical history was admitted to the emergency service with abdominal pain, belching and nausea. He denied any other symptoms, and no previous surgical operations were recorded. Physical examination showed a large mass in the left scrotum below the mid-point of the inner thigh of the patient in an upright position. A CT scan confirmed the diagnosis of a GIS. A laparoscopic TAPP procedure was decided upon as the best course of treatment.
The patient underwent a successful repair procedure. The operation time was 150 min. No intraoperative blood transfusion was necessary. The patient's diet was resumed on the first day post surgery, and the postoperative hospital stay was three days.
Laparoscopic TAPP repair is a safe and feasible method for surgically managing GIS hernias.
巨大腹股沟阴囊（GIS）疝在临床环境中很少见，并且常常多年被忽视。如果这种类型的疝在患者直立位时下降至大腿内侧中点以下，则被定义为“巨大”疝。GIS疝的腹腔镜修补方法在技术上具有挑战性。据称，腹腔镜手术比开放手术方法有几个优点，疼痛更少且恢复更快。本视频的目的是评估经腹腹膜前腹腔镜修补术（TAPP）治疗GIS疝的疗效。
一名65岁男性，无相关既往病史，因腹痛、嗳气和恶心入住急诊。他否认有任何其他症状，且既往无手术记录。体格检查显示，在患者直立位时，左侧阴囊内有一个位于大腿内侧中点以下的巨大肿块。CT扫描确诊为GIS疝。决定采用腹腔镜TAPP手术作为最佳治疗方案。
患者手术修复成功。手术时间为150分钟。术中无需输血。患者术后第一天恢复饮食，术后住院三天。
腹腔镜TAPP修补术是手术治疗GIS疝的一种安全可行的方法。
