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内镜下经疝囊转位术(eTHS)在腹外疝修补术中的应用-技术描述。

Endoscopic transposition with the hernial sac (eTHS) in ventral hernia repair - technical description.

机构信息

- Universidade Federal de Goiás, Professor Associado, Faculdade de Medicina - Departamento de Cirurgia - Goiânia - GO - Brasil.

- Colégio Brasileiro de Cirurgiões, Titular - Goiânia - GO - Brasil.

出版信息

Rev Col Bras Cir. 2021 Mar 8;48:e20202672. doi: 10.1590/0100-6991e-20202672. eCollection 2021.

Abstract

Incisional hernia is a late complication of the most frequent after abdominal surgeries, with resulting morbidity that can worsen the condition. The treatment has been done both by open techniques, using screens or not, and by laparoscopic and robotic methods, which use them systematically. However, introducing a permanent foreign body into the tissues requires more surgical time, despite not closing the parietal defect in most cases and a higher risk of infections. New technologies have been trying to improve these results, with absorbable prostheses (biological or synthetic), but their high cost and recurrences remain a severe problem. Even so, standard repair establishes reinforcement with screens, routine, and whether the approach is traditional or mini-invasive. The authors report their first case of endoscopic repair of incisional hernia, which occurred two years ago, with a Brazilian technique already fifty years old: the transposition with the hernia sac proposed by Prof. Alcino Lázaro da Silva in 1971.

摘要

切口疝是腹部手术后最常见的晚期并发症之一,由此导致的发病率可能会使病情恶化。治疗方法包括开放式手术(使用或不使用补片)、腹腔镜和机器人方法,这些方法系统地使用补片。然而,将永久性异物引入组织需要更长的手术时间,尽管在大多数情况下不会封闭壁层缺陷,而且感染风险更高。新技术一直在努力改善这些结果,使用可吸收的假体(生物或合成),但它们的高成本和复发仍然是一个严重的问题。即便如此,标准修复还是采用补片进行加固,这是常规操作,无论采用的是传统方法还是微创方法。作者报告了他们的第一例内镜修复切口疝的病例,该病例发生在两年前,采用了一种已有 50 年历史的巴西技术:由 Alcino Lázaro da Silva 教授于 1971 年提出的疝囊转位术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52be/10683414/05ed688213a6/rcbc-48-e20202672-g001.jpg

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