Le Bouëdec G, Kauffmann P, Mille P, Scherrer C, Raiga J, Dauplat J
Centre Jean Perrin, Service de Chirurgie, Clermont-Ferrand.
J Chir (Paris). 1995 May;132(5):259-63.
Incisional hernia occurred in a patient after laparoscopic hysterectomy. The greater omentum was incarcerated in the tract of the suprapubic trocar (12 mm diameter). Diagnosis and treatment were performed during a second laparoscopy procedure. The greater number of trocar instruments and their larger diameter increases the risk of parietal morbidity after laparoscopic procedures. Elective closures of trocar incisions is recommended when exceeding 10 mm. Prevention of extra-umbilical incisional hernias and dehiscences appears to be more effective when suture is performed under laparoscopic vision with the trocar inserted. Both the aponevrosis and the peritoneal membrane should be treated.
一名患者在腹腔镜子宫切除术后发生了切口疝。大网膜嵌顿于耻骨上套管针(直径12毫米)的通道内。在第二次腹腔镜手术过程中进行了诊断和治疗。腹腔镜手术后,套管针器械数量越多且直径越大,发生腹壁并发症的风险就越高。当套管针直径超过10毫米时,建议选择性关闭套管针切口。在插入套管针的情况下,于腹腔镜视野下进行缝合时,预防脐外切口疝和切口裂开似乎更有效。腱膜和腹膜均应进行处理。