Department of Surgery of the Hospital Nossa Senhora das Graças, Curitiba, Brazil.
JSLS. 2021 Apr-Jun;25(2). doi: 10.4293/JSLS.2021.00021.
There is a dearth of studies on laparoscopic treatment of female groin hernia. Our study assessed the outcome of groin hernia repair in females employing the totally extraperitoneal laparoscopic (TEP) access.
Data of all females who were subjected to laparoscopic groin herniorrhaphy, from August 1998 to February 2020 were retrospectively obtained. Groin hernia repair was routinely started with TEP access.
A total of 2,399 patients who underwent laparoscopic groin herniorrhaphy, 254 (10.6%), were females. Most females (n = 191; 75.2%) had single hernia and the remaining (n = 63; 24.8%) had bilateral hernias, making a total of 317 hernias operated. Indirect inguinal hernia was the most common hernia type (72.5%), followed by femoral hernia (17.4%) and direct hernia (10.1%). Prior lower abdominal operations were recorded in 97 (38.2%) patients. Conversion to a laparoscopic transabdominal preperitoneal procedure was performed due to technical difficulties to dissect the preperitoneal space in 17 patients (6.7%) and to open procedure in only one patient (0.4%) with incarcerated femoral hernia in whom an incidental perforation of the small bowel occurred. Intra- and postoperative complications occurred in 12 (4.7%) and 15 (5.9%) patients, respectively. There was no mortality. Most patients (n = 221; 87%) were discharged on the same day of the operation. Hernia recurrence was diagnosed in 6 patients (2.4%).
It is concluded that females with groin hernia may be successfully treated with totally extraperitoneal laparoscopic access, with low conversion and complication rates.
关于女性腹股沟疝的腹腔镜治疗研究甚少。本研究评估了女性经完全腹膜外腹腔镜（TEP）入路行腹股沟疝修补术的结果。
回顾性收集 1998 年 8 月至 2020 年 2 月期间所有接受腹腔镜腹股沟疝修补术的女性患者的数据。腹股沟疝修补术通常采用 TEP 入路进行。
共有 2399 例女性接受了腹腔镜腹股沟疝修补术，其中 254 例（10.6%）为女性。大多数女性（n=191；75.2%）患有单侧疝，其余 63 例（24.8%）为双侧疝，共进行了 317 例疝手术。最常见的疝类型为间接腹股沟疝（72.5%），其次是股疝（17.4%）和直接疝（10.1%）。97 例（38.2%）患者有下腹部既往手术史。由于在解剖腹膜前间隙时遇到技术困难，17 例（6.7%）患者转为腹腔镜经腹腹膜前修补术，1 例（0.4%）患者转为开放手术，该患者为股疝嵌顿，小肠意外穿孔。12 例（4.7%）患者发生术中及术后并发症，15 例（5.9%）患者发生术后并发症。无死亡病例。大多数患者（n=221；87%）在手术当天出院。6 例（2.4%）患者诊断为疝复发。
经完全腹膜外腹腔镜入路治疗女性腹股沟疝可获得良好的效果，且中转开腹率和并发症发生率较低。
