Kneessy K, Weinbaum F
New York Hospital Medical Center of Queens, Flushing 11355, USA.
Surg Laparosc Endosc. 1997 Apr;7(2):171-2.
During the repair of a Richter's type incarcerated right femoral hernia via an infrainguinal approach, the incarcerated loop of bowel retracted back into the abdominal cavity before the bowel could be adequately examined for viability. To avoid a laparotomy to identify and possibly resect the involved loop of bowel, a laparoscope was introduced into the open femoral sac. Pneumoperitoneum was obtained, and the involved loop of small bowel was identified via the laparoscope, grasped with a grasping forceps from a second trocar port, and brought out through the hernia sac. The bowel was directly visualized and assessed for viability. This procedure required only a 5-mm trocar incision rather than an infraumbilical laparotomy incision, thus potentially minimizing postoperative morbidity, decreasing the length of hospital stay, and reducing postoperative pain. We propose this technique as a potentially useful alternative to a laparotomy in this situation on selected patients.
在通过腹股沟下入路修复里氏型嵌顿性右股疝时，在能够充分检查肠管活力之前，嵌顿的肠袢就回缩到腹腔内。为避免开腹以识别并可能切除受累肠袢，将腹腔镜插入开放的股疝囊。建立气腹后，通过腹腔镜识别出受累的小肠袢，从第二个套管针穿刺孔用抓钳抓住，然后通过疝囊拉出。直接观察肠管并评估其活力。该操作仅需一个5毫米的套管针切口，而不是脐下开腹切口，因此有可能将术后发病率降至最低，缩短住院时间，并减轻术后疼痛。我们建议在这种情况下，对选定的患者采用这种技术作为开腹手术的一种潜在有用的替代方法。
