Felix E L, Michas C
Surgical Associates of Fresno, CA.
J Laparoendosc Surg. 1993 Feb;3(1):1-8. doi: 10.1089/lps.1993.3.1.
To determine if laparoscopic inguinal herniorrhaphy can be performed safely in unselected patients, the authors' first 100 consecutive laparoscopic inguinal hernia repairs were reviewed. All patients with inguinal hernias who were candidates for general anesthetic were accepted for the study. Their ages ranged from 18 to 84 years. One hundred and six hernias were laparoscopically repaired in 95 males and 4 females. One male patient required an open hernia repair. The first 14 patients were repaired with a preperitoneal patch and plug technique, and the next 85 with the double-buttress transabdominal preperitoneal approach. Two pieces of polypropylene mesh were stapled to the transversalis fascia, ileopubic tract, and Cooper's ligament after the preperitoneal dissection of the hernia was completed. The first piece was placed over the indirect space, with a slit for the cord medially, and the second piece was placed over the entire direct and indirect area. Patients have been followed from 8-18 months. To date, no recurrence has developed. Complications have included seroma, inferior epigastric bleeding, trocar hernia, and neuralgia. Patients have returned to work and normal activity in 2 days to 2 weeks, with an average of 1 week.
为了确定腹腔镜腹股沟疝修补术能否在未经挑选的患者中安全实施，作者回顾了其最初连续进行的100例腹腔镜腹股沟疝修补术。所有适合全身麻醉的腹股沟疝患者均纳入本研究。他们的年龄在18岁至84岁之间。95例男性和4例女性患者共106处疝接受了腹腔镜修补。1例男性患者需要行开放式疝修补术。前14例患者采用腹膜前补片和塞子技术进行修补，接下来的85例采用双支撑经腹腹膜前入路。在完成疝的腹膜前分离后，将两片聚丙烯补片用吻合器固定于腹横筋膜、髂耻束和库珀韧带。第一片置于间接疝间隙上方，内侧有一用于精索的切口，第二片置于整个直疝和间接疝区域上方。患者随访时间为8至18个月。迄今为止，尚未出现复发。并发症包括血清肿、腹壁下出血、套管针疝和神经痛。患者在2天至2周内恢复工作和正常活动，平均为1周。
