腹股沟区和腹壁解剖和手术培训资料.pptVIP

腹股沟区和腹壁的解剖和手术;Objectives目的;What is a Hernia?什么是疝？;What causes a Hernia?疝产生的原因;REALITY CHECK!事实证明！;HERNIAS疝气;;切 口 疝;造 瘘口 旁 疝;骨架;;;Myopectineal OrificeTriple Triangles of the Groin耻骨肌孔的三组三角;;Indirect Inguinal Hernia腹股沟斜疝;;Direct Inguinal Hernia腹股沟直疝;Hernia Statistics疝气统计表;Adult Inguinal Hernia成人腹股沟疝;Methods of Repair修补方法;;;Current Hernia Repair Techniques当代的疝修补技术;Tension Repairs张力修补;;Advantages of Tension Repair张力修补的优点;4. Abrahamson. Maingot’s Abdominal Operations. Vol 1. 9th ed. Appleton Lange: East Norwalk, Conn; 1990:chap 11. 5. Lichtenstein. Hernia Repair Without Disability. 2nd ed. St. Louis, Mo: Ishiyaku Euroamerica, Inc; 1986. ;Tension-Free Repairs无张力修补; Introduced in 1984 1984年引进 Improved results over prior methods of repair 在之前的修补方法基础上取得进展 Open anterior approach 前路开放手术 Steps 步骤 deal with the sac 处理疝囊 mesh sutured to floor and around spermatic cord (between transversalis fascia and external oblique)补片缝扎以覆盖和包裹精索（在腹横筋膜和腹外斜肌之间） running or interrupted sutures连续或间断缝合;;Lichtenstein Technique Lichtenstein技术;;Bard Perfix Plug Patch 网塞修补 ;Erosion of a shrunken soft Marlex? plug into the bladder wall.膀胱壁内缩小的软Marlex? 塞 的腐蚀情况Image courtesy of Parviz K. Amid, MD.;Introduced in 19981998年确立 A secure posterior repair from a simple anterior approach由简单的前入路方法发展成为安全后壁修补方法 Lowest reported recurrence rates 低复发率 Low cost 低成本 3 points of protection三点保护;Laparoscopic HerniorrhaphyLaparoscopic 腔镜手术;TAPP = TransAbdominal PrePeritoneal 经腹腔腹膜前修补 Laparoscopic Approach Laparoscopic 方法 Posterior Repair 后壁修补;TAPP with UltraPro使用UltraPro的经腹腔腹膜前修补;TEP;TEP with UltraPro 用 UltraPro的完全腹膜外修补;Ventral/Incisional Hernia腹壁疝/切口疝;Agenda日程;Facts事实;VENTRAL HERNIA: anatomy腹壁解剖??;EXTERNAL OBLIQUE 腹外斜肌;INTERNAL OBLIQUE 腹内斜肌;TRANSVERSE ABDOMINUS腹横肌;Ventral Hernia Repair腹壁疝修补;History: Repair Techniques修补技术发展史;Ventral Hernia Techniques*腹壁疝技术;Issues!实例;Recurrence Rate of Incisional Hernia Repair