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腹腔镜经腹腹膜前双侧腹股沟疝修补术中进入 Retzius 间隙的新方法。

A new approach to enter Retzius space in laparoscopic transabdominal preperitoneal bilateral inguinal hernia repair.

机构信息

Department of General Surgery I Section, Shaanxi Provincial People's Hospital, No. 256 Youyixi Road, Beilin District, Xi'an , 710068, China.

Function Testing Lab, Shaanxi Provincial People's Hospital, Xi'an, 710068, China.

出版信息

BMC Surg. 2023 Jan 30;23(1):26. doi: 10.1186/s12893-023-01917-8.

Abstract

BACKGROUND

To investigate the feasibility, safety and efficacy of the right-side approach to enter Retzius space in laparoscopic transabdominal preperitoneal bilateral inguinal hernia repair.

METHODS

Retrospective analysis was performed on 189 patients who were diagnosed with bilateral inguinal hernia preoperatively or intraoperatively and underwent selective TAPP in the General Surgery I Section of Shaanxi Provincial People's Hospital from January 2015 to September 2020. 94 cases were performed using the right-side approach (research group), and 95 cases with conventional approach (control group). Intraoperative and postoperative conditions of the two groups were observed and compared.

RESULTS

All operation were completed successfully. The operative time of research group was significantly shorter than that of control group (128.8 ± 35.4 vs 144.1 ± 40.9 min, P = 0.006). There were no significant differences in postoperative hospital stay, VAS score on first postoperative day, incidence of seroma and hematoma, urinary retention and other complications (P > 0.05). None of the patients occured hernia recurrence, mesh infection, intestinal obstruction and other complications.

CONCLUSIONS

The right-side approach to enter Retzius space is safe and feasible in TAPP surgery of bilateral inguinal hernia. Compared with the conventional approach, it can shorten the operative time and has certain advantages.

摘要

背景

探讨腹腔镜经腹腹膜前双侧腹股沟疝修补术中右侧入路进入Retzius 间隙的可行性、安全性和有效性。

方法

回顾性分析 2015 年 1 月至 2020 年 9 月在陕西省人民医院普外科 I 节诊断为双侧腹股沟疝的 189 例患者,根据术中是否选择行选择性 TAPP 分为右侧入路组(研究组,94 例)和常规入路组(对照组,95 例)。观察并比较两组患者的术中及术后情况。

结果

所有手术均顺利完成。研究组的手术时间明显短于对照组(128.8 ± 35.4 比 144.1 ± 40.9 min,P = 0.006)。两组术后住院时间、术后第 1 天 VAS 评分、血清肿和血肿发生率、尿潴留等并发症发生率差异均无统计学意义(P > 0.05)。两组均无疝复发、网片感染、肠梗阻等并发症发生。

结论

右侧入路进入 Retzius 间隙在双侧腹股沟疝 TAPP 手术中是安全可行的,与常规入路相比,可缩短手术时间,具有一定优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5634/9885556/c3995b5d66dd/12893_2023_1917_Fig1_HTML.jpg

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