经腹壁外穿刺带线结扎固定补片的tep手术方法探讨.doc

经腹壁外穿刺带线结扎固定补片的TEP手术方法探讨 李学远，李健，陈红兵，苏清华，王健，杨少伟，陈雅婷（523750广东东莞，东莞市黄江医院外二科） 【摘 要】 目的 探讨腹腔镜全腹膜外疝修补术(totally extraperitoneal prosthesis，TEP)中经腹壁外穿刺结扎固定补片方法的安全性和可行性。方法 回顾分析2010年 4月至2013年 12月我院普外科施行的TEP手术59例患者，其中腹股沟斜疝48例，直疝8例，股疝3例，3例由TEP手术中途改为TAPP。所有患者随机分成A、B两组，A组经腹壁外穿刺带线结扎固定补片；B组采用疝钉枪(美国强生5mm 腔镜疝修补专用钉枪)固定补片。结果 比较两组病人手术时间、术中出血量、手术后疼痛、血清肿等手术后并发症，发现两组无明显差异但住院费用有明显差异。结论 经腹壁外穿刺带线结扎固定补片的TEP手术安全有效，该方法法不需要特殊器械，容易学会掌握并可明显降低医疗费用。 【关键词】腹壁外穿刺结扎，补片固定，腹股沟疝 【Key words】 The discussion on method of TEP through extraperitoneal puncture in suture ligation to fix mesh LI Xue-yuan, LI Jian, CHEN Hong-bing,etal. Department of General surgery,Huangjiang Hospital,Dongguan 523750,China【Abstract】Objective: To explore the feasibility and security of laparoscopic total extraperitoneal hernia repair (totally extraperitoneal prosthesis,TEP) through extraperitoneal puncture in suture ligation to fix mesh.Methods A retrospective analysis was made to the treatment of 59 cases of TEP surgery, including 48 cases of indirect inguinal hernia，8 cases of direct inguinal hernia and 3 cases of femoral hernia, 3 cases of TEP surgery were changed to TAPP surgery，in the general surgery department of our hospital from April 2010 to December 2013. All patients were randomly divided into A ，B two groups，A group of extraperitoneal puncture in suture ligation to fix mesh, B group of the hernia nail gun (5 mm laparoscopic hernia repair special nail gun of Johnson Johnson) to fix mesh. Result ?Compare two groups of patients with operation time, intraoperative blood loss, pain after operation, seroma and complications after the operation found no difference between the two groups but significantly differences in hospitalization expenses. Conclusion TEP surgery through extraperitoneal puncture in suture ligation to fix mesh is safe and effective, this method needs no special equipment, easy to learn and can obviously reduce the medical expenses. key words：extraperitoneal puncture ligation；fix mesh；inguinal hernia