Gritsiuta Andrei, Gologram Makayla, Myers Christopher, Esper Christopher
Surgical Services, University of Pittsburgh Medical Center, Pittsburgh, USA.
Plastic Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA.
Cureus. 2023 Feb 20;15(2):e35207. doi: 10.7759/cureus.35207. eCollection 2023 Feb.
Inguinal hernia repair, although a common procedure, can present in complicated ways such as a sliding inguinal bladder hernia (IBH). This rare type of hernia can alter a patient's quality of life by obstructing urination, requiring manual scrotal compression to fully empty the bladder, and lead to devastating complications such as hydronephrosis and kidney failure. Treatment is typically by open inguinal hernia repair with manual bladder reduction, but this method poses risks of iatrogenic injury to the bladder. Within this case series, IBH repairs via open and robotic-assisted laparoscopic procedures are compared, and the morbidity and mortality of each method are analyzed. Although risk of recurrence is similar for both procedures, robotic surgeries are linked to decreased postoperative pain and length of hospital stay. The ease of dissection of pelvic anatomy and detailed view of the associated structures that robotic surgery can provide during a complex hernia repair encourages its use for IBH.
腹股沟疝修补术虽是一种常见手术,但可能会以复杂方式出现,比如滑动性腹股沟膀胱疝(IBH)。这种罕见类型的疝会因排尿受阻改变患者生活质量,需要手动压迫阴囊才能完全排空膀胱,还会导致诸如肾积水和肾衰竭等严重并发症。治疗通常采用开放腹股沟疝修补术并手动还纳膀胱,但这种方法存在医源性膀胱损伤风险。在这个病例系列中,对通过开放手术和机器人辅助腹腔镜手术进行的IBH修补术进行了比较,并分析了每种方法的发病率和死亡率。虽然两种手术的复发风险相似,但机器人手术与术后疼痛减轻和住院时间缩短有关。机器人手术在复杂疝修补术中能够提供的盆腔解剖结构易于分离以及相关结构的详细视野,促使其用于IBH修补。