外科理论与实践 ›› 2024, Vol. 29 ›› Issue (04): 323-328.doi: 10.16139/j.1007-9610.2024.04.09
张一忠1, 汤睿2, 王廷峰3, 司仙科4, 叶乐斌5, 柳楠2, 项世骏6, 吴卫东6()
收稿日期:
2024-05-19
出版日期:
2024-07-25
发布日期:
2024-11-15
通讯作者:
吴卫东,E-mail: wwd701202@126.com基金资助:
ZHANG Yizhong1, TANG Rui2, WANG Tingfeng3, SI Xianke4, YE Lebin5, LIU Nan2, XIANG Shijun6, WU Weidong6()
Received:
2024-05-19
Online:
2024-07-25
Published:
2024-11-15
摘要:
目的:报道侧方入路单孔腹腔镜完全腹膜外腹股沟疝(L-SILTEP)修补这一应用于特定情况下腹股沟疝的全新术式。方法:回顾性分析2021年6月至2024年3月宁波大学附属第一医院、上海交通大学医学院附属第一人民医院、同济大学附属东方医院完成的110例腹股沟疝L-SILTEP的资料,分析病例资料、手术细节、住院时间和术后情况。结果:手术均顺利完成,无中转。中位手术时间55 (41.25, 70) min。术中平均出血量5 (2,10) mL。术中腹壁下血管损伤5例(4.5%),精索损伤1例(0.9%)。术后6、24和48 h疼痛平均视觉模拟评分(VAS)分别为(3.0 ± 0.8)分、(1.9 ± 0.7)分和(1.1 ± 0.4)分。平均住院时间(3.3 ± 0.7)d。术后并发症常见为腹股沟区血清肿(9例,8.2%),腹膜外间隙血肿1例(0.9%),阴囊积液1例(0.9%)。结论:L-SILTEP安全、方便、有效。因其技术要求高,应用限于特定的病人和医师。开展该手术需要重视培训和技术细节,谨慎开展。
中图分类号:
张一忠, 汤睿, 王廷峰, 司仙科, 叶乐斌, 柳楠, 项世骏, 吴卫东. 侧方入路单孔腹腔镜完全腹膜外腹股沟疝修补术(附110例报告)[J]. 外科理论与实践, 2024, 29(04): 323-328.
ZHANG Yizhong, TANG Rui, WANG Tingfeng, SI Xianke, YE Lebin, LIU Nan, XIANG Shijun, WU Weidong. Lateral approach single-incision laparoscopic totally extraperitoneal inguinal hernia repair: a report of 110 cases[J]. Journal of Surgery Concepts & Practice, 2024, 29(04): 323-328.
[1] | 郑民华, 马君俊. 腹腔镜手术技术平台的现状与发展趋势[J]. 外科理论与实践, 2020, 25(3):181-183. |
Zheng M H, Ma J J. Current status and trends of laparoscopic surgery technology platforms[J]. J Surg Concepts Pract, 2020, 25(3):181-183. | |
[2] | 张一忠, 齐长磊, 帅勇锋, 等. 侧方入路单孔腹腔镜完全腹膜外腹股沟疝修补术(附37例报告)[J]. 腹腔镜外科杂志, 2022, 27(3):198-202,214. |
ZHANG Y Z, QI C L, SHUAI Y F, et al. Lateral single incision laparoscopic totally extraperitoneal technique for inguinal hernia repair: with a report of 37 cases[J]. J Laparosc Surg, 2022, 27(3):198-202,214. | |
[3] | 中华医学会外科学分会疝与腹壁外科学组, 中华医学会外科学分会腹腔镜与内镜外科学组. 单孔腹腔镜腹股沟疝手术规范化操作中国专家共识(2023版)[J]. 中国实用外科杂志, 2023, 43(1):34-47. |
China Hernia Society, Chinese Society of Surgery, Chinese Medical Association; China Society of Laparoscopic and Endoscopic Surgery, Chinese Society of Surgery, Chinese Medical Association. Chinese expert consensus on clinical practice of single-incision laparoscopic inguinal hernia repair (2023 edition)[J]. Chin J Pract Surg, 2023, 43(1):34-47. | |
[4] | 王廷峰, 吴卫东, 陈军杰, 等. 后鞘后经脐缘单孔腹腔镜完全腹膜外腹股沟疝修补术:500 例回顾性分析[J]. 复旦学报(医学版), 2022, 49(5):697-703. |
WANG T F, WU W D, CHEN J J, et al. Single incision laparoscopic totally extraperitoneal inguinal hernia repair by posterior sheath approach:a retrospective analysis of 500 cases[J]. Fudan Univ J Med Sci, 2022, 49(5):697-703. | |
[5] | 李健文, 乐飞, 薛佩. 浅谈腹腔镜腹股沟疝修补术的进展及现状[J]. 上海医学, 2022, 45(4):221-225. |
LI J W, YUE F, XUE P. A brief discussion on the progress and current situation of laparoscopic inguinal hernia repair[J]. Shanghai Med J, 2022, 45(4):221-225. | |
[6] | 中华医学会外科学分会疝和腹壁外科学组, 中华医学会外科学分会腹腔镜和内镜外科学组, 大中华腔镜疝外科学院. 腹腔镜腹股沟疝手术操作指南(2017版)[J]. 外科理论与实践, 2017, 22(6):483-488. |
Chinese Medical Association Surgical Branch Hernia and Abdominal Wall Surgery Group, Chinese Medical Association Surgical Branch Laparoscopic and Endoscopic Surgery Group, Greater China Academy of Laparoscopic Hernia Surgery. Operative guidelines for laparoscopic inguinal hernia surgery (2017 edition)[J]. J Surg Concepts Pract, 2017, 22(6):483-488. | |
[7] | DAES J. The enhanced view-totally extaperitoneal technique for repair of inguinal hernia[J]. Surg Endosc, 2012, 26(4):1187-1189. |
[8] | WEI C T, CHEN Y S, SUN C K, et al. Single-incision laparoscopic total extraperitoneal repair for a Grynfeltt hernia: a case report[J]. J Med Case Rep, 2014,8:16. |
[9] | NAKAHARA Y, WAKASUGI M, NAGAOKA S, et al. Single-incision retroperitoneal laparoscopic repair of superior lumbar hernia using self-fixating ProGrip mesh: a case report[J]. Int J Surg Case Rep, 2020,67:120-122. |
[10] |
BITTNER R, ARREGUI M E, BISGAARD T, et al. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)][J]. Surg Endosc, 2011, 25(9):2773-2843.
doi: 10.1007/s00464-011-1799-6 pmid: 21751060 |
[11] |
BITTNER R, MONTGOMERY M A, ARREGUI E, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society)[J]. Surg Endosc, 2015, 29(2):289-321.
doi: 10.1007/s00464-014-3917-8 pmid: 25398194 |
[12] | PERIVOLIOTIS K, TZOVARAS G, SARAKATSIANOU C, et al. Current status of single- port versus multi- port approach in laparoscopic inguinal hernia mesh repair: an up- to- date systematic review and meta-analysis[J]. Hernia, 2019, 23(2):217-233. |
[13] | CARDINALI L, MAZZETTI C H, CADENAS FEBRES A, et al. Prospective randomized study comparing single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal (TEP) inguinal hernia repair at 2 years[J]. Surg Endosc, 2018, 32(7):3262-3272. |
[14] | RAJAPANDIAN S, BHUSHAN C, SABNIS S C, et al. Single incision multiport versus conventional laparoscopic inguinal hernia repair: a matched comparison[J]. J Minim Access Surg, 2018, 14(1):44-51. |
[15] | 李健文. 腹腔镜腹股沟疝修补术的再认识[J]. 外科理论与实践, 2016, 21(2):98-100. |
LI J W. Reconceptualisation of laparoscopic inguinal hernia repair[J]. J Surg Concepts Pract, 2016, 21(2):98-100. | |
[16] | 覃代镭, 魏士博, 李航宇. 基于膜性解剖的精细全腹膜外修补术[J]. 外科理论与实践, 2018, 23(4):310-313. |
QIN D L, WEI S B, LI H Y. Fine total extraperitoneal repair based on membranous anatomy[J]. J Surg Concepts Pract, 2018, 23(4):310-313. | |
[17] | 董泾青. 膜解剖理念在腹腔镜完全腹膜外疝修补术中的应用[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5):472-475. |
DONG J Q. Application of membrane anatomy TEP in treatment of inguinal hernia[J]. Chin J Hernia Abdom Wall Surg(Electronic Edition), 2020, 14(5):472-475. | |
[18] | 吴卫东, 王廷峰, 司仙科, 等. 单孔腹腔镜全腹膜外疝修补术在前列腺癌根治术后腹股沟疝中应用研究[J]. 中国实用外科杂志, 2023, 43(6):683-687. |
WU W D, WANG T F, SI X K, et al. Application of single-incision totally extraperitoneal inguinal hernia repair in inguinal hernia after radical prostatectomy(a report of 30 cases)[J]. Chin J Pract Surg, 2023, 43(6):683-687. | |
[19] |
LEE Y J, KIM J H, KIM C H, et al. Single incision laparoscopic totally extraperitoneal hernioplasty: lessons learned from 1,231 procedures[J]. Ann Surg Treat Res, 2021, 100(1):47-53.
doi: 10.4174/astr.2021.100.1.47 pmid: 33457397 |
[20] | WAKASUGI M, HASEGAWA J, IKEDA Y. Single-incision laparoscopic totally extraperitoneal inguinal hernia repair with tumescent local anesthesia: report of more than 2000 procedures at a day-surgery clinic[J]. Surg Today, 2021, 51(4):545-549. |
[21] | 张明逸, 陈以宽. 髂腹股沟区血管解剖特点及腹腔镜下腹股沟疝无张力修补术血管损伤的应对技巧[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(3):209-212. |
ZHANG M Y, CHEN Y K. Vascular anatomical characteristics in iliac inguinal region and vascular injury management in laparoscopic inguinal hernia repair[J]. Chin J Hernia Abdom Wall Surg(Electronic Edition), 2020, 14(3):209-212. |
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