Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Bonn, Germany.
Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital of Bonn, Bonn, Germany.
Injury. 2022 Feb;53(2):802-808. doi: 10.1016/j.injury.2021.09.043. Epub 2021 Oct 1.
This study presents a detailed documentation of a total endoscopic anterior pelvic approach (TAPA) for plate fixation of a symphyseal disruption. The purpose of this work is to describe a minimally invasive technique as a possible method for reducing complications and hospitalization. Other goals included giving technical recommendations and assessing potential pitfalls and problems of this new surgical approach. Surgery was performed in an interdisciplinary setting by an experienced orthopaedic and general surgeon. The first endoscopic approach used to visualize the injury was the same as is used for endoscopic hernia surgery. The repositioning of the symphysial rupture was achieved either through external fixation or indirectly with traction and a pelvic binder. Plate positioning and fixation were achieved through two additional, minimally invasive incisions. The endoscopic approach shows multiple advantages, such as no detachment of the rectus abdominis muscle and smaller skin incisions. Furthermore, this approach could lessen the incidence of hernia and postoperative pain. We see the presented technique as a simple and innovative surgical method for treating symphyseal disruption.
本研究详细记录了一种全内镜前路骨盆入路（TAPA），用于固定耻骨联合分离的钢板。本研究的目的是描述一种微创技术，作为减少并发症和住院时间的可能方法。其他目标包括提供技术建议，并评估这种新手术方法的潜在陷阱和问题。手术由一位经验丰富的骨科和普外科医生在跨学科环境中进行。用于可视化损伤的第一个内镜入路与用于内镜疝手术的入路相同。耻骨联合断裂的复位是通过外部固定或间接通过牵引和骨盆带实现的。钢板的定位和固定是通过另外两个微创切口实现的。内镜入路具有多个优点，例如不分离腹直肌和更小的皮肤切口。此外，这种方法可以降低疝和术后疼痛的发生率。我们认为所提出的技术是治疗耻骨联合分离的一种简单而创新的手术方法。
