Department of General Surgery, Basaksehir State Hospital, Istanbul, Turkey.
Department of General Surgery, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2022 Aug;32(8):842-847. doi: 10.1089/lap.2021.0601. Epub 2021 Dec 17.
Endoscopic total extraperitoneal (TEP) is used increasingly in inguinal hernias. Perhaps the most fundamental difficulty of the classical TEP method is that the dissection plan it offers is overly limited, which is among the reasons why techniques other than TEP are preferred in large scrotal hernias. This study discusses our experience with the extended view totally extraperitoneal (e-TEP) method, which significantly expands the dissection plan compared to the classical method. Patients who had inguinal hernia surgery in 2018 and 2019 were retrospectively analyzed, and 21 male patients with L3 inguinal hernia by European Hernia Society classification, who underwent laparoscopic e-TEP surgery, were included in the study. Patient data were obtained from the hospital's electronic database and patient files. One year after the surgery, the patients were invited to the hospital by telephone and re-examined. The median patient age was 47 years. The mean duration of surgery was 43.6 minutes, and the median postoperatively pain score in the first 24 hours was 1.975. Zig maneuver was performed in 85.7%, and drains were placed in 33.4% of patients. In 28.6% of patients, the peritoneal violation occurred. However, there was no conversion to another surgical technique. The mean length of stay was 1.33 days. Two patients had seroma, one had scrotal edema, and one had urinary retention. No recurrence was observed in any patient during the 1-year follow-up. According to our experience, the e-TEP technique can be safely performed in scrotal hernias as it offers a larger dissection plane. It also allows patients with large scrotal hernias to benefit from all the advantages of the TEP technique.
经腹腹膜前疝修补术（TEP）在腹股沟疝中的应用日益增多。经典 TEP 方法最基本的困难之一是其提供的解剖计划过于有限，这也是除 TEP 以外的技术在大型阴囊疝中更受欢迎的原因之一。本研究讨论了我们使用扩展视图完全腹膜外（e-TEP）方法的经验，与经典方法相比，该方法显著扩展了解剖计划。回顾性分析了 2018 年和 2019 年接受腹股沟疝手术的患者，纳入了 21 例欧洲疝学会分类为 L3 腹股沟疝的男性患者，行腹腔镜 e-TEP 手术。患者数据来自医院的电子数据库和患者档案。术后 1 年，通过电话邀请患者到医院复查。中位患者年龄为 47 岁。手术平均时间为 43.6 分钟，术后 24 小时内疼痛评分中位数为 1.975。85.7%的患者行 Zig 动作，33.4%的患者放置引流管。28.6%的患者发生腹膜破裂。但无 1 例转为其他手术技术。平均住院时间为 1.33 天。2 例患者发生血清肿，1 例发生阴囊水肿，1 例发生尿潴留。在 1 年的随访中，没有患者出现复发。根据我们的经验，e-TEP 技术可安全应用于阴囊疝，因为它提供了更大的解剖平面。它还使患有大型阴囊疝的患者受益于 TEP 技术的所有优势。
