Atabek U, Spence R K, Pello M, Alexander J, Story L, Camishion R C
Department of Surgery, UMDNJ-Robert Wood Johnson Medical School at Camden.
Am Surg. 1994 Apr;60(4):255-8.
The recent interest in laparoscopic surgery has raised some concerns that large numbers of surgeons were recommending this "minimally invasive" approach in procedures such as inguinal herniorrhaphy before the availability of adequate data regarding safety and benefits. To determine current experience and preference levels for laparoscopic inguinal herniorrhaphy (LH), we conducted a mail survey of New Jersey surgeons. Of 531 respondents, 430 (81%) preferred a traditional inguinal incision approach over a laparoscopic approach (8%). Of 344 general surgeon respondents, 227 (66%) had experience with laparoscopic cholecystectomy, but only 56 (16%) had experience with LH. This latter group had performed only an average of 9.2 laparoscopic herniorrhaphies, with a median of five cases. Most of these 56 surgeons with LH experience indicated a preference for inguinal incision herniorrhaphy although 19 surgeons who had performed 10 or more LH cases showed a slight preference for LH (11 to 8). The primary reasons for choosing LH included "less pain" and "quicker recovery." The primary reasons for choosing inguinal incision herniorrhaphy included having a "better known procedure" and avoiding general anesthesia. Our survey indicates that the laparoscopic approach to inguinal hernia repair has currently accumulated few proponents in the surgical community since many surgeons are waiting for more data on the procedure.
最近对腹腔镜手术的关注引发了一些担忧，即在有关安全性和益处的充分数据可得之前，大量外科医生就在腹股沟疝修补术等手术中推荐这种“微创”方法。为了确定目前对腹腔镜腹股沟疝修补术（LH）的经验和偏好程度，我们对新泽西州的外科医生进行了邮件调查。在531名受访者中，430名（81%）更喜欢传统的腹股沟切口方法，而不是腹腔镜方法（8%）。在344名普通外科医生受访者中，227名（66%）有腹腔镜胆囊切除术的经验，但只有56名（16%）有LH的经验。后一组平均只进行了9.2例腹腔镜疝修补术，中位数为5例。这56名有LH经验的外科医生中，大多数表示更喜欢腹股沟切口疝修补术，尽管19名进行了10例或更多LH手术的外科医生对LH略有偏好（11比8）。选择LH的主要原因包括“疼痛较轻”和“恢复较快”。选择腹股沟切口疝修补术的主要原因包括“手术更熟悉”和避免全身麻醉。我们的调查表明，由于许多外科医生正在等待更多关于该手术的数据，目前腹腔镜腹股沟疝修补术在外科界的支持者很少。
