De Gols Johan, Berkmans Evelien, Timmers Mieke, Vanluyten Cedric, Ceulemans Laurens J, Deferm Nathalie P
Department of Abdominal Surgery, Sint-Franciscus Hospital, 3550 Heusden-Zolder, Belgium.
Department of Thoracic Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
J Clin Med. 2024 Sep 11;13(18):5386. doi: 10.3390/jcm13185386.
The Lichtenstein procedure is one of the most performed surgeries worldwide. However, proper examination to exclude a femoral hernia is often not performed, resulting in a high number of missed hernias. For patients in whom a femoral hernia is suspected pre- or intraoperatively, we describe a novel surgical technique of a femoral extension to the classic Lichtenstein repair. We aim to investigate its safety and clinical outcome. The femoral-extended Lichtenstein is applied when a femoral hernia is suspected. The fascia transversalis is opened, the lacunar ligament incised, and the hernia reduced. A self-gripping mesh covers the femoral orifice equally on all sides. In a prospective single-center study, we compared 50 consecutive femoral-extended to 50 classic Lichtenstein repairs, evaluating operative time, patient-reported pain (intensity, duration), and recurrence. The technique seems feasible and safe. Apart from 3 min additional surgical time, no difference in pain scoring or hernia recurrence was observed between both groups. We successfully introduced a femoral-extended Lichtenstein repair for patients with suspected femoral herniation.
利氏手术是全球开展最为频繁的手术之一。然而，常常未进行恰当检查以排除股疝，导致大量疝被漏诊。对于术前或术中怀疑有股疝的患者，我们描述了一种对经典利氏修补术进行股部扩展的新型手术技术。我们旨在研究其安全性和临床效果。当怀疑有股疝时应用股部扩展利氏手术。打开腹横筋膜，切开陷窝韧带，还纳疝内容物。一种自固定补片从各个方向均匀覆盖股环。在一项前瞻性单中心研究中，我们将连续50例股部扩展利氏手术与50例经典利氏修补术进行比较，评估手术时间、患者报告的疼痛（强度、持续时间）及复发情况。该技术似乎可行且安全。除了手术时间增加3分钟外，两组在疼痛评分或疝复发方面未观察到差异。我们成功地为怀疑有股疝突出的患者引入了股部扩展利氏修补术。
