Peng Xudong, Ge Yinggang, Zhang Jianwen, Wei Zhengqiang, Zhang Hongyu
Gastrointestinal Surgical Unit, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Oncol. 2022 Oct 18;12:1036145. doi: 10.3389/fonc.2022.1036145. eCollection 2022.
Perineal hernia after abdominoperineal resection (APR) is a troublesome problem, and severe cases require surgical treatment. However, perineal hernia repair is challenging, especially when combined with intestinal adhesions. The difficulty of the operation lies in performing adhesiolysis and mesh placement under poor visibility. While there are traditional, laparoscopic and even robotic methods of performing this procedure, no easy and minimally-invasive approach has been reported. Here, we report the case of a patient with perineal hernia, who underwent transanal total mesorectal excision (TaTME) port-assisted laparoscopic perineal hernia repair. The operation was successful, the postoperative recovery was uneventful, the patient's symptoms improved significantly, and no recurrence was found during the 4-month follow-up. The availability and safety of TaTME port-assisted perineal hernia repair provide a promising approach for hernia repair. Compared with traditional perineal or laparoscopic abdominal approaches, this procedure is less invasive and results in a better field of vision.
腹会阴联合切除术(APR)后发生会阴疝是一个棘手的问题,严重病例需要手术治疗。然而,会阴疝修补术具有挑战性,尤其是合并肠粘连时。手术的难点在于在视野不佳的情况下进行粘连松解和补片放置。虽然有传统、腹腔镜甚至机器人手术方法来实施该手术,但尚未报道简单且微创的方法。在此,我们报告一例会阴疝患者,其接受了经肛门全直肠系膜切除术(TaTME)端口辅助腹腔镜会阴疝修补术。手术成功,术后恢复顺利,患者症状显著改善,在4个月的随访期间未发现复发。TaTME端口辅助会阴疝修补术的可行性和安全性为疝修补提供了一种有前景的方法。与传统的会阴或腹腔镜腹部入路相比,该手术创伤更小,视野更好。