Neufang T, Lepsien G
Klinik für Allgemeinchirurgie, Georg-August-Universität Göttingen.
Zentralbl Chir. 1994;119(6):432-44.
We report our experience with laparoscopic repair of inguinal hernias since Dec. 1990. The initially used "plug & patch-technique" was abandoned because of high recurrence rates for primary hernias and other disadvantages. In Feb. 1992 we started with a transperitoneal-preperitoneal repair using closure of the defect with sutures as well as posterior wall reinforcement with polypropylene mesh. Based on established conventional techniques, the procedure has evolved and results in quick recovery and low recurrence rates. As compared to anterior techniques, a superior repair of large posterior wall defects, bilateral, femoral and especially recurrent hernias is achieved. Disadvantages are the transabdominal approach and the need of general anesthesia. The technique used in Göttingen is presented in detail. Between 2/92 and 9/93 we repaired 249 hernias (including 44 recurrences) in 207 patients. Major complications were observed in 1.6%. Up to now, we found 4 recurrences (1.6%, follow-up 87%, 5-24 months).
我们报告自1990年12月以来腹腔镜腹股沟疝修补术的经验。最初使用的“补片修补技术”因原发性疝复发率高及其他缺点而被弃用。1992年2月，我们开始采用经腹腔腹膜前修补术，用缝线关闭缺损并使用聚丙烯网片加强后壁。基于已确立的传统技术，该手术不断发展，实现了快速康复且复发率低。与前路手术相比，能更好地修补较大的后壁缺损、双侧疝、股疝，尤其是复发性疝。缺点是经腹入路及需要全身麻醉。详细介绍了哥廷根所采用的技术。在1992年2月至1993年9月期间，我们为207例患者修补了249例疝（包括44例复发性疝）。观察到的主要并发症发生率为1.6%。截至目前，我们发现4例复发（1.6%，随访率87%，随访时间5 - 24个月）。
