Schafmayer A, Schleef J, Neufang T, Barthel M, Lepsien G
Klinik und Poliklinik für Allgemeinchirurgie, Georg-August-Universität, Göttingen.
Zentralbl Chir. 1993;118(12):754-8.
The success of the laparoscopic cholecystectomy was remarkable and well-founded, thus it seems necessary to examine whether this procedure could be also used for other general surgical operations. Since Dec. 29th, 1990 the transperitoneal repair of hernias by laparoscopy has been performed in 177 patients. The patients were followed up in regular intervals. The first 100 patients were treated with the "plug repair" technique of Schultz and Corbitt. In this group one recurrence (4 month after operation) and one dislocation of a mesh roll (2 weeks after the operation) were observed. In the middle of April 92 we changed the laparoscopic operation technique to a preperitoneal mesh fortification analogous to the procedure of Stoppa. This requires a detailed preparation of all possible positions of the hernia (medial and lateral compartment). A cutting through all layers of the abdominal wall can be avoided. After the preparation all abdominal wall defects can be fortified effectively and clearly. In this group we have treated 77 patients, so far without complications. With the exception of scrotal hernias and adhesions the laparoscopic hernioplastique can be used in any indication of inguinal hernia repair. An evaluation of the long-term results can only be performed in the future although the early results are encouraging.
腹腔镜胆囊切除术的成功显著且有充分依据，因此似乎有必要研究该手术是否也可用于其他普通外科手术。自1990年12月29日起，已对177例患者进行了腹腔镜经腹疝修补术。对患者进行定期随访。前100例患者采用舒尔茨和科比特的“补片修补”技术治疗。该组观察到1例复发（术后4个月）和1例补片卷移位（术后2周）。1992年4月中旬，我们将腹腔镜手术技术改为类似于斯托帕手术的腹膜前补片加强术。这需要详细准备疝的所有可能位置（内侧和外侧腔隙）。可以避免切开腹壁的所有层次。准备完成后，所有腹壁缺损都能得到有效且清晰的加强。在该组中，我们已治疗77例患者，目前尚无并发症。除阴囊疝和粘连外，腹腔镜疝修补术可用于腹股沟疝修补的任何适应证。尽管早期结果令人鼓舞，但长期结果的评估只能在未来进行。
