腹腔镜疝修补术(英文版)LaparoscopicVentralHerniaRepair

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腹腔镜复合补片无张力修补术治疗腹壁切口疝的临床体会

腹腔镜复合补片无张力修补术治疗腹壁切口疝的临床体会陆逢春;黄鹤光;陈燕昌;林贤超;林荣贵;杨媛媛【期刊名称】《腹腔镜外科杂志》【年(卷),期】2012(17)8【摘要】Objective:To evaluate the application and the reliability of laparoscopic herniorrhapliy with composite mesh in treating ventral incisional hernia. Methods:The clinical data of 56 patients who suffered from ventral incisional hernia and underwent iapa-roscopic herniorrhaphy with composite mesh from Jan. 2007 to Jan. 2012 were analyzed retrospectively. Results: Laparoseopic herniorrhaphy with composite mesh was successfully performed for 53 patients,3 cases were converted to open operation because of extensive, adhesion. The operating time was 70-320 min (median ,110 min). In these cases, 2 cases of concealed hernia were found, the time of grade one nursing was one clay,eating and out-of-bed activity occurred in 24 hours after operation,1 case of prolonged pain and infection was found respectively,there was no recurrence in the follow-up. Conclusions: It is feasible and reliable in treating ventral incisiona! hernia with laparoscopic herniorrhaphy with composite mesh after complete dissection of adhesions.%目的:探讨腹腔镜复合补片无张力修补术治疗腹壁切口疝的应用价值及可靠性.方法:回顾分析2007年1月至2012年1月为56例患者行腹腔镜复合补片修补术的临床资料.结果:3例因广泛粘连中转开腹,53例成功完成手术.手术时间70 -320 min,中住手术时间110 min.术中发现隐匿性疝2例.术后Ⅰ级护理时间1天,术后24 h即恢复进食并下床活动.术后发生较长时间疼痛1例、感染1例.随访至今均未发现复发.结论:术后并发切口疝的患者于腹腔镜下分离粘连、采用复合补片修补是安全可行的.【总页数】3页(P598-600)【作者】陆逢春;黄鹤光;陈燕昌;林贤超;林荣贵;杨媛媛【作者单位】福建医科大学附属协和医院,福建福州,350001;福建医科大学附属协和医院,福建福州,350001;福建医科大学附属协和医院,福建福州,350001;福建医科大学附属协和医院,福建福州,350001;福建医科大学附属协和医院,福建福州,350001;福建医科大学附属协和医院,福建福州,350001【正文语种】中文【中图分类】R656.2+4【相关文献】1.部分可吸收补片无张力修补术治疗腹壁切口疝30例临床观察 [J], 院存珍;樊晨2.应用补片无张力修补术治疗腹股沟疝40例临床体会 [J], 解植修;解云超3.应用补片法治疗腹壁切口疝的临床体会 [J], 赵宏;梁志平4.腹腔镜腹腔内补片植入术治疗腹壁切口疝的效果及对机体炎症反应的影响 [J],曹金良5.比较腹腔镜腹腔内与开放腹膜前间隙补片置入术治疗腹壁切口疝的效果 [J], 徐云飞; 司亚卿; 王钊; 袁甲祥; 王群; 王涛因版权原因，仅展示原文概要，查看原文内容请购买。

腹腔镜腹壁疝修补术SAGES指南

腹腔镜腹壁疝修补术SAGES指南David Earle;J.Scott Roth;Alan Saber;陈大伟【期刊名称】《中国微创外科杂志》【年(卷),期】2017(017)011【总页数】4页(P961-964)【作者】David Earle;J.Scott Roth;Alan Saber;陈大伟【作者单位】;;;上海交通大学医学院附属新华医院崇明分院普外科,上海 202105【正文语种】中文腹壁疝修补的目标是解除病人的症状和(或)治愈疝本身。

近年来,越来越多的医生开展腹腔镜腹壁疝修补术，但是选择开放手术还是腹腔镜手术治疗腹壁疝仍有争议。

该指南旨在为外科医生开展腹腔镜腹壁疝修补术时，在病人的选择、手术技术以及术后处理方面提供帮助。

用疝、腹壁、外科、腔镜、英语、人类等主题词，在Medline上进行文献检索。

所有的文献由美国胃肠道内镜外科医师协会(Society of American Gastrointestinal Endoscopic Surgeons，SAGES)指南委员会指定的工作组成员阅读审查。

为便于读者阅读，指南分为以下4个方面：①与开放式修补的对比；②术前考虑；③手术技术；④术后管理。

腹腔镜腹壁疝修补术治疗腹壁疝安全可靠，其与开放腹壁疝修补术相比，术后复发率无显著性差异，但腹腔镜腹壁疝修补术后恢复快、切口感染少，在近1年的随访中，腹腔镜疝修补术病人术后疼痛明显比开放式疝修补术要轻。

腹壁疝修补术的目标是解除疝的症状和(或)预防将来与疝有关的问题，如疼痛、急性嵌顿、疝增大。

对于所有的腹壁疝修补术，术前要确定手术目标，并向病人说明。

外科医生要根据个人的经验、医院的条件来决定是否采用腹腔镜技术完成腹壁疝手术。

在手术之前要充分考虑到增加手术难度的因素，如疝缺损大小、嵌顿等。

术前先要明确疝缺损的大小，因为大的缺损会增手术难度。

关于腹腔镜腹壁疝修补术与疝大小的关系，目前有3种观点：①>10 cm的缺损要慎用腹腔镜疝修补术；②<3 cm的缺损没有必要采用腹腔镜手术，但Medline没有任何证据支持这个提议；③不论缺损大小都可以使用腹腔镜腹壁疝修补术。

腹腔镜腹股沟疝修补术后复发疝再次腹腔镜经腹腹膜前疝修补术的经验

•210•中华疝和腹壁外科杂志(电子版)2019年6月第13卷第3期Chin J Hemia Abdominal SurgfElectronic Editim),June2019,W1.13,No.3•论著•腹腔镜腹股沟疝修补术后复发疝再次腹腔镜经腹腹膜前疝修补术的经验黄俊蔡小勇靳小建雷宇【摘要】目的总结腹腔镜腹股沟疝修补术(laparoscopic inguinal hemia repair,LIHR)后复发，应用腹腔镜经腹腹膜前疝修补术(laparoscopic trans-abdominal preperitoneal,TAPP)进行再次修补的临床经验。

方法回顾性分析2010年3月至2018年6月，广西医科大学第二附属医院收治的既往LIHR术后复发55例患者的临床资料，均行TAPP再次修补。

术中在高位T型离断疝囊，旷置远端疝囊及既往补片，重新放置补片。

结果手术均顺利完成，无中转手术，平均手术时间(60.2±18.1)min,术后住院时间1〜5d,术后尿潴留3例(5.5%),腹股沟区血清肿3例(5.5%)；无肠道损伤、膀胱损伤，无补片感染；电话或信件随访4〜28个月，无再次复发患者。

结论T型离断疝囊、旷置补片的TAPP术治疗既往LIHR术后复发的腹股沟疝患者是可行的，由于高位T型离断疝囊，避免剥离既往手术创面，旷置原补片，使得手术更为安全。

【关键词】疝，腹股沟；疝修补术；腹腔镜；腹膜前；复发Clinical experience of TAPP for recurrent hernia after laparoscopic inguinal hernia repair Huang Jun,Cai Xiaoyong,Jin Xiaojian,Lei Yu.Department of G eneral Surgery,Second Affiliated Hospital of G uangxiMedical University,Guangxi,Nanning530021,ChinaCorresponding author:Cai Xiaoyong,Email:cxy0771@[Abstract]Objective To summarize clinical experience of re-repair for recurrent hemia afterlaparoscopic inguinal hemia repair(LIHR)using laparoscopic transabdominal preperitoneal(TAPP)repairwith the surgical method of replacing mesh by bypassing the previous mesh T-shaped transected hemia sac,and explore the safety and reliability of this method.Methods Fifty-five recurrent cases after laparoscopicpreperitoneal repair for inguinal hemia in Second Affiliated Hospital of Guangxi Medical University fromMarch2010to June2018were retrospectively analyzed.Intraoperatively,the distal hemia sac and theprevious mesh were retained and the new mesh was replaced with the high T-shaped transected hemia sac.Results All the surgery were successfully completed without converting to open surgery.The averagesurgical time was(60.2±18」)minutes.The postoperative hospital stay was1to5daays.Postoperative urinaryretention occurred in3(5.5%)cases and seroma in the inguinal region in3(5.5%)cases.No intestinal injury,bladder injury,or mesh infection occurred.Follow-up was performed by telephone or mail for4to28months,showing no recurrence.Conclusion It is feasible to treat recurrent inguinal hemia after LIHR by TAPP withT-shaped transected hemia sac and mesh exclusion.Because the high T-shaped hemia sac is transected,peelingoff the previous surgical wound is avoided and the original mesh is retained,which makes the surgery safer.[Key words]Hemia,inguinal;Herniorrhaphy;Laparoscopes;Preperitoneal;Recurrence腹腔镜经腹腹膜前疝修补术(laparoscopic trans-abdominal preperitoneal hemiarepair,TAPP)⑴与腹腔镜完全腹膜外疝修补术(laparoscopic totally extra-DOI:10.3877/cma.j.issn.l674-392X.2019.03.005基金项目：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170083)作者单位：530021南宁，广西医科大学第二附属医院普通外科通信作者：蔡小勇，Email:cxy0771@ peritoneal,TEP)⑵的出现使得腹股沟疝手术方式得到了革命性的改变，这种基于肌耻骨孔解剖的腹膜前修补的后入路手术方式因其微创美容、恢复快等效果得到了越来越多患者的青睐。

腹腔镜腹股沟疝修补 TAPP TEP

Байду номын сангаас
Methods
Results
Baseline data
Quality assessment
Recurrence
Postoperative pain scores
Operation time
Return to usual activities
Hospital stay
Surgeon's experience
limitation
Response
Citation
Conclusion
Conclusion
On the basis of current evidence, TEP as a modified and more complex laparoscopic procedure than TAPP did not lead to a significant difference in aspects of clinical outcomes and complications. Therefore, we firstly recommended TAPP for laparoscopic hernia repair, especially for nonexpert surgeons. Further choices would be made according to the specific clinical characteristics of patients and surgeons.
Subgroup analysis - state, location, experience
Safety
limitation
Limitation

腹腔镜疝PPT课件

公元1962年，聚丙烯补片应用于疝修补。公元1975年，法国医生Stoppa使用涤纶布行巨大网片加强内脏囊手术 (giant prosthetic reinforce of the visceral sac, GPRVS),即Stoppa手术。公元1984年，Lichtenstein创造了“无张力疝成型术”的新概念。公元1987年，Lichtenstein手术定型。公元1991年，Arregui首次报道了TAPP。公元1992年，Fitzgibbongs首次实施了IPOM。公元1993年，Phillips、Mckernan及Law各自实施了TEP。公元1999年，美国医生Kugel在Stoppa手术的基础上加以改进，描述了
公元1814年，Hesselbach发现并命名了直疝三角（Hesselbach三角）
谢谢！公元1823年，法国巴黎大学Bogros在血管外科硕士论文中提出“腹膜前间
隙”，后称Bogros间隙。公元1858年,瑞典解剖学家Retzius提出Retzius间隙。公元1876年，英国爱丁堡的Thomas Annandale第一个提出了腹膜外修补的概念。
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经腹腹膜前腹股沟疝修补术(TAPP)
适应症：与开放式腹膜前修补术相同，复发疝和双侧疝是TAPP的良好适应症。
绝对禁忌症：不能耐受全麻，腹腔内感染，腹膜炎。
相对禁忌症：腹腔内粘连，腹腔积液，凝血障碍，嵌顿性疝。
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经腹腹膜前腹股沟疝修补术(TAPP)
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全腹膜外腹股沟疝修补术(TEP)
适应症：理论上与TAPP相同，对于下腹部有手术史（特别是前列腺手术史）、某些复发疝（特别是腹膜前间隙曾植入过补片）的患者，腹膜前间隙已存在粘连，应慎用TEP；对于病史长、巨大的阴囊疝、难复性疝，也应慎用TEP。

【管理资料】腹腔镜疝修补术(英文版)LaparoscopicVentralHerniaRepair汇编

• Hernia Contents are trapped and painful • Abdominal Pain and/or a Painful Bulge • Blood Supply to trapped contents may be
compromised
Preoperative Work-up
腹腔镜疝修补术(英文版)LaparoscopicVentralHerni
aRepair
Where Do Hernias Occur?
• Abdominal Wall
– At a previous surgical incision – At the umbilicus – Above the umbilicus (epigastrium) – In the inguinal region (groin)
– Secure the Mesh to the abdominal wall
• Prevent movement of the mesh prior to incorporation
Laparoscopic Ventral Hernia
Laparoscopic Ports
Hernia
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5
5
Laparoscopic Inguinal Hernia
• Evaluation by Surgeon
– Physical Examination
• CT Scan
– May or may not be needed – At the discretion of the surgeon
Surgical Technique
• Key Components:

修补的英语短语

修补的英语短语友谊就像陶器，破了可以修补;爱情好比镜子，一旦打破就难重圆。

下面就由店铺为大家带来关于修补的英语短语集锦，希望大家能有所收获。

关于修补的相关短语修补 fix up修补 piece up修补程序 patching a program修补行为 remedy action修补程式 Security Patch ;图像修补 image inpainting ; image mending错误修补 bug patch传统修补 traditional hernioplasty ; Traditional repair套管修补 casing salvaging ; casing repair ;修补袋 repaired bags缺陷修补 imperfection mend修补本 rebacked;修补不良 bodging;修补刀 fettling knife;修补工 patcher;修补工作 patchwork;修补合成 {生} repair synthesis;修补痕 burl mark (织疵);修补胶 repair sheets;修补轮胎 full capping;修补着色 inked; inking关于修补的相关单词mendrepair关于修补的相关短句patch clothes;修补衣服The mend in your dress scarcely shows.你衣服上修补的地方几乎看不出来。

关于修补的相关例句1. They started to mend the woodwork and paint the walls.他们开始修补木建部分，粉刷墙壁。

2. Several fishermen sat on wooden barrels, tending their nets.几个渔夫坐在木桶上修补渔网。

3. One strut had fractured and been crudely repaired in several places.一根撑木出现了裂痕，有几处已进行了粗略的修补。

腹腔镜疝修补术的现状(英文)

腹腔镜疝修补术的现状(英文)梁熙贤【期刊名称】《现代临床医学生物工程学杂志》【年(卷),期】1996(2)4【摘要】腹股沟疝修补术是一种发展中外科技术。

本文回顾了腹腔镜疝修补术的发展史,重点阐述腹腔镜腹膜前疝修补术(transabdominal preperitoneal hernia repair,TAPP)和全腹膜外修补术(totally extraperitoneal,TEP),1979年Gcr首先施行腹腔镜疝修补术,腹股沟修补术使用置钉器,1990年Sehultg的塞补法(plug and patch)腹腔镜疝修补术但复发率高,1990年底发展的TAPP亦有腹腔并发症发生,1992年的(TEP)是腹膜前间隙的分离,完全在腹腔外,所以避免了与TAPP手术发生的腹腔并发症。

因此TEP更为临床所接受,TAPP,TEP与开放无张力手术方法比较显示腹腔镜疝修补术是一安全有效并发症少的方法,可取代传统的开放手术方式。

在双侧性疝气,复发性和复杂的腹股沟疝,其优点更为突出。

在过去的6年里,腹腔镜疝修补方法的成功应用,代替了传统的手术方法,对那些单侧原发性疝修补术的exact作用仍然delineated和开放的没有张力的方法,临床术后疼痛较少,早期可恢复工作和正常活动,但费用较大,较好的经验是反复使用器械,进一步改进技术,以减少费用,任何类型手术方法评价的决定因素在于远期的复发率。

然而,目前所报告腹腔镜疝修补术者至今也只有3年,只有经过长期的追踪才能说明腹腔镜疝修补术是否能为腹股沟修补术的最佳方法。

【总页数】6页(P247-252)【关键词】腹腔镜疝修补术;并发症;手术方法;复发率;腹膜;腹股沟;安全【作者】梁熙贤【作者单位】香港玛嘉烈医院外科【正文语种】中文【中图分类】R656【相关文献】1.腹腔镜下腹股沟疝修补术并发症的诊断与治疗现状 [J], 董宝利2.成年女性腹腔镜腹股沟疝修补术的治疗现状 [J], 董元; 秦伟; 姜超3.腹腔镜腹股沟疝修补术治疗现状及护理进展 [J], 顾云燕;张越4.腹腔镜下腹壁疝修补术的临床治疗现状及其研究进展 [J], 刘刚[1]5.腹腔镜下腹壁疝修补术的应用现状 [J], 王大柱因版权原因，仅展示原文概要，查看原文内容请购买。

腹腔镜与开放疝修补术治疗腹壁疝的疗效比较研究

腹腔镜与开放疝修补术治疗腹壁疝的疗效比较研究李海鹏;庞春宏【期刊名称】《腹腔镜外科杂志》【年(卷),期】2017(22)7【摘要】Objective:To evaluate the clinical application effect of laparoscopic ventral hernia repair (LVHR) and open ventral hernia repair (OVHR) for the treatment of abdominal wall hernia.Methods:The clinical data of 52 patients with hernia of abdominal wall between May 2010 and Aug.2016 were retrospectively analyzed.27 patients underwent LVHR,25 patients underwent OVHR.Results:The laparoscopic and the open group's average operation time was (65.4±18.7) min and (84.5±31.5) min respectively,the average hospital stay after surgery was (6.3±1.8) d and (9.8±6.2) d,the VAS pain score of two groups on the first day after operation was (3.4±1.1) and (6.4±1.5),the differences were statistical ly significant (P<0.05).The pain score of 1 week and 1 month after operation showed no statistically significant difference (P>0.05).The hospitalization cost of laparoscopic group was more than that of open group(P<0.05).After a follow up of 2-24 months (12 months in median),incidence of complications in the two groups were 22.2% and 20.0% without recurrence cases,there was no statistically significant difference(P>0.05).Conclusions:The LVHR is safe and feasible in repairing abdominal wall hernia with advantages of little injury and pain,rapid recovery.LVHR isworthy of clinical promotion.%目的:评价腹腔镜腹壁疝修补术(laparoscopic ventral hernia repair,LVHR)与开放修补术治疗腹壁疝的临床应用效果.方法:回顾分析2010年5月至2016年8月收治的52例腹壁疝患者的临床资料,其中27例行LVHR,25例行开放手术.结果:两组手术时间[(65.4±18.7) min vs.(84.5±31.5) min]、术后住院时间[(6.3±1.8) d vs.(9.8±6.2) d]、术后第1天疼痛评分VAS[(3.4±1.1) vs.(6.4±1.5)]差异有统计学意义(P<0.05),术后1周及1个月的疼痛评分差异无统计学意义(P>0.05).两组并发症发生率(22.2% vs.20.0%)差异无统计学意义(P>0.05),腔镜组住院费用高于开放组(P<0.05).术后随访2~24个月,中位随访时间12个月,两组均无复发病例.结论:LVHR修补腹壁疝是安全、可行的,具有患者创伤小、康复快等优点,值得临床推广.【总页数】4页(P544-547)【作者】李海鹏;庞春宏【作者单位】鹤壁市人民医院,河南鹤壁,458030;鹤壁市人民医院,河南鹤壁,458030【正文语种】中文【中图分类】R656.2+4【相关文献】1.腹腔镜腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的疗效比较[J], 朱冠鹏2.腹腔镜无张力疝修补术与开放式无张力疝修补术治疗腹股沟疝的疗效观察 [J], 蒋崇雨3.腹腔镜腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的疗效比较[J], 朱冠鹏4.腹腔镜疝修补术治疗腹壁疝的疗效分析 [J], 麻继文5.开放式无张力疝修补术与腹腔镜疝修补术治疗腹股沟疝疗效比较 [J], 邹亮;潘险峰;杨彦;柏力;李敏因版权原因，仅展示原文概要，查看原文内容请购买。

腹腔镜疝修补术(英文版)LaparoscopicVentralHerniaRepair

Who Requires Treatment
– Pain or Discomfort – Enlarging Hernias – Intestinal Obstruction
• Nausea, Vomiting, Abdominal Distention – Incarceration or Strangulation
谢谢！
教学资料整理
• 仅供参考，
Laparoscopic Ventral Hernia
Laparoscopic Ports
Hernia
5
10
5
5
Laparoscopic Inguinal Hernia Laparoscopic Ports
Hernia
10பைடு நூலகம்
Hernia
5
5
Ventral Hernia Defect
Mesh Used to Patch Defect
• Evaluation by Surgeon – Physical Examination
• CT Scan – May or may not be needed – At the discretion of the surgeon
Surgical Technique
• Key Components: – Reduce the hernia contents – “Patch” the defect in the fascia with Mesh • Mesh is incorporated into the abdominal wall by the body • Reinforces the defect in the fascia – Secure the Mesh to the abdominal wall • Prevent movement of the mesh prior to incorporation

腹腔镜疝修补术与开放无张力疝修补术的对比研究

腹腔镜疝修补术与开放无张力疝修补术的对比研究李兵;蒋泰君;黄振国;李军【摘要】Objective:To compare the therapeutic effect of laparoscopic herniorrhaphy and open tension-free hernioplasty in the treatment of inguinal hernia. Methods: The clinical data of two hundred and twenty patients who underwent these two different inguinal hernia repair operations between Jul. 2005 and Oct. 2010 were retrospectively reviewed. 136 patients underwent open surgery, and 84 patients received laparoscopy. Results:The postoperative pain time,normal activity time,and hospital stay in laparoscopic group were better than those in opengroup(P<0. 05). Conclusions: Laparoscopie hernia repair has less trauma,less pain better cosmetic result and quicker recovery than open operation. And it is especially suitable for bilateral and recurrent hernias.%目的:对比腹腔镜疝修补术与常规开放无张力修补术治疗腹股沟疝的临床疗效.方法:回顾分析2005年7月至2010年10月腹腔镜疝修补术及开放式无张力疝修补术的临床资料,其中136例行开放式无张力疝修补术,84例行腹腔镜手术.结果:腹腔镜组术后患者疼痛时间、下床时间、住院时间均优于开放组(P＜0.05).结论:腹腔镜疝修补术具有患者创伤小、疼痛轻、康复快、切口美观等优点,疗效较开放手术好,为腹股沟疝的治疗提供了更好的选择,尤其适合双侧疝、复发疝.【期刊名称】《腹腔镜外科杂志》【年(卷),期】2012(017)003【总页数】3页(P206-208)【关键词】疝,腹股沟;疝修补术;腹腔镜检查;对比研究【作者】李兵;蒋泰君;黄振国;李军【作者单位】重庆市长寿区第三人民医院,重庆长寿,401221;重庆市长寿区第三人民医院,重庆长寿,401221;重庆市长寿区第三人民医院,重庆长寿,401221;重庆市长寿区第三人民医院,重庆长寿,401221【正文语种】中文【中图分类】R656.2+1腹股沟疝是外科常见病，自1887年Bassini首创加强腹股沟管后壁疝修补，百余年来腹股沟疝的治疗经历了漫长的演变过程。

腹腔镜下无张力修补治疗腰疝3例报告

腹腔镜下无张力修补治疗腰疝3例报告王雷;彭泉;陈亮;于华杰;田开亮;陈旭;赵成功【摘要】[Summary] The paper reported 3 cases of lumbar hernia treated by laparoscopic tension-free repair between October 2013 and May 2015 in our hospital .During the operation , we returned the herniary content , closed defect of abdominal , and then fixed a mesh around the margins of the hernia defect by helical tack .All the operations were successfully performed .The operative time was 85, 60, and 70 min,respectively.The intraoperative blood loss was 15, 10, and 25 ml,respectively.The postoperative hospital stay was 5, 4, and 6 d,respectively.The follow-up time was 6,18,and 26 months,respectively.During the follow-ups, two patients had postoperative pain and returned to unrestricted movement within 3 months after surgery .No recurrence was observed .We deem that for patients with lumbar hernia laparoscopic tension-free repair is simple and feasible .%本文报道我科2013年10月～2015年5月采用完全腹腔镜下无张力修补治疗3例腰疝。

腹腔镜腹股沟疝修补术的临床应用

腹腔镜腹股沟疝修补术的临床应用江鸣;钱小星;周高潮;汤永胜;陈克辉;胡开兵;李良;刘咸罗【期刊名称】《腹腔镜外科杂志》【年(卷),期】2011(16)1【摘要】目的:探讨腹腔镜腹股沟疝修补术(laparoscopic inguinal hernia repair,LIHR)的临床应用经验.方法:回顾分析2007年3月至2010年4月为65例腹股沟疝患者行LIHR的临床资料.其中斜疝46例,直疝19例;单侧疝55例(包括复发疝2例),双侧疝10例.结果:经腹腹膜前修补术45例,完全腹膜外修补术20例.手术时间40～160min,术后均未使用镇痛剂,住院3～7d,平均5d,主要并发症为阴囊气肿、阴囊血清肿或血肿、暂时性感觉神经异常、尿潴留,术后随访3个月～3年,1例复发.结论:LIHR安全可靠,术后疼痛轻,康复快,复发率低.严格把握手术适应证,经过规范培训,不断提高手术技巧后,开展LIHR可获得最佳的社会和卫生经济学效益.%Objective:The purpose of this study was to evaluate the clinical experience of laparoscopic inguinal hernia repair (LIHR). Methods:The clinical data of 65 inguinal hernia patients who were performed LIHR from Mar. 2007 to Apr. 2010,including 19 direct inguinal hernias and 46 indirect hernias, were retrospectively analyzed. Among them ,55 patients suffered unilateral hernias and 10 patients suffered bilateral hernias,including 2 recurrent hernias. Results:Forty-five of the study cohort were performed with transabdominal preperitoneal prosthesis and 20 of them were performed with totally extraperitoneal prosthesis. The operating time was 40160min. During the postoperative period, none of the patients neededanalgesics. The hospital stay was 5d (range, 3-7d). Most of the complications observed were scrotum emphysema, hematoma or seroma, transient neurapraxia and urinary retention. All the patients were followed up for 3-36 months and 1 recurrence case was observed. Conclusions: LIHR is safe and reliable, with little pain ,fast postoperative recovery and low recurrence rate. LIHR can offer the best clinical results and social cost-effectiveness only when restrictive indications are followed and it should be performed by standard trained and skilled surgeons who never stop sharpening their operational skills.【总页数】4页(P27-30)【作者】江鸣;钱小星;周高潮;汤永胜;陈克辉;胡开兵;李良;刘咸罗【作者单位】合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011;合肥市第二人民医院,安徽,合肥,230011【正文语种】中文【中图分类】R656.2+1【相关文献】1.经内环补片单点固定法全腹膜外腹腔镜腹股沟疝修补术临床应用研究 [J], 钟春林;赵平武;王大川;刘文;于颖娟;邓志刚2.经皮内环补片单点固定法全腹膜外腹腔镜腹股沟疝修补术临床应用研究 [J], 赵攀; 李英杰; 张海燕; 杨雪兰; 赵平武; 王德良; 李健波; 何运胜; 刘志武; 黄坤; 贾顺虎; 彭宣福3.腹腔镜腹股沟疝修补术在基层医院的临床应用 [J], 任建军; 龙俊彪; 何忠智4.经腹腔腹膜前腹腔镜腹股沟疝修补术的临床应用研究 [J], 钟腾猛5.ERAS在腹腔镜腹股沟疝修补术患者围手术期的临床应用 [J], 祝江涛因版权原因，仅展示原文概要，查看原文内容请购买。

腹腔镜造口旁疝补片修补术的临床体会

腹腔镜造口旁疝补片修补术的临床体会姚远【期刊名称】《中国实用医药》【年(卷),期】2015(000)032【摘要】ObjectiveTo investigate surgical method and clinical effect of laparoscopic parastomal hernia patch herniorrhaphy.MethodsA total of 18 patients with parastomal hernia were taken as study subjects. They received operation by laparoscopic parastomal hernia patch, and effect was analyzed.ResultsAll the 16 cases received successful operation, and 2 cases received alternative laparotomy. Their operation time lasted for60~130 min, with average time as 95 min. Their postoperative hospital stay time was 4~7 d, with average time as 5.5 d. No operation death,infection or intestinal leakage occurred. Postoperative follow-up for 3~28 months, with average time as 15 months, showed no case with recurrence or long-term complications.ConclusionLaparoscopic parastomal hernia patch herniorrhaphy is safe and feasible, and it provides ideal short-term operation effect.%目的：探讨腹腔镜下应用补片修补造口旁疝的手术方法和临床效果。

腹腔镜疝修补术新进展PPT课件

定义：
体内某个脏器或组织离开其正常解剖部位，通过先天或后天形成的薄弱点、缺损、或间隙进入另一个部位，称为疝。
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广西医科大学微创外科中心※
疝的类型
类型腹股沟斜疝腹股沟直疝股疝切口疝脐疝、白线疝、造口疝
所占腹外疝比例 75%～90% 5%～15% 3%~5% 1% <1%
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广西医科大学微创外科中心
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广西医科大学微创外科中心
Lau和Patil 提出4 cm 以下的缺损不需要固定补片，费用更低，Koch等对TEP补片固定或不固定的RCT研究则证实这一观点。
国内李健文、丁锐等在此方面的尝试亦得到相似结果。这都为今后LIHR的进一步发展提供了尝试与探讨的方向。但是由于目前缺少设计严格的RCT研究,限制了该术式的临床应用及推广。
1~30月 0
6月~4.5年 1
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广西医科大学微创外科中心
对国内外学者多年研究成果总结如下：
①LIHR术后疼痛、神经感觉异常轻于开放式手术;
②LIHR恢复正常活动时间短于开放式手术; ③LIHR术后住院时间较开放式手术短; ④LIHR复发率与开放式无张力手术相近,低于传统
有张力手术; ⑤LIHR的总并发症率与开放式手术相同, L IHR腹
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广西医科大学微创外科中心
随着科技的发展，腹腔镜的出现给疝外科手术带来了前所未
有的技术革新。
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广西医科大学微创外科中心
腹腔镜腹股沟疝修补术(LIHR)：
⑴经腹膜前法（transabdominal preperitoneal approach，
TAPP）
⑵完全经腹膜外法(totally extraperitoneal approach，TEP)

腹腔镜疝修补术(英文版)

• Hernia Contents are trapped and painful • Abdominal Pain and/or a Painful Bulge • Blood Supply to trapped contents may be
compromised
Preoperative Work-up
– A defect in that layer allows intra-abdominal contents (i.e.. fat, intestines) to bulge through the defect.
Where Do Hernias Occur?
• Abdominal Wall
– At a previous surgical incision – At the umbilicus – Above the umbilicus (epigastrium) – In the inguinal region (groin)
– Secure the Mesh to the abdominal wall
• Prevent movement of the mesh prior to incorporation
Laparoscopic Ventral Hernia
Laparoscopic Ports
Hernia
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10
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Laparoscopic Inguinal Hernia
– Reduce the hernia contents – “Patch” the defect in the fascia with Mesh
• Mesh is incorporated into the abdominal wall by the body

腹腔镜下经腹膜前疝修补术和开放无张力疝修补术治疗腹股沟嵌顿疝的临床研究

腹腔镜下经腹膜前疝修补术和开放无张力疝修补术治疗腹股沟嵌顿疝的临床研究目的:本研究通过观察腹腔镜下经腹膜前疝修补术(laparoscoplctrans-abdominal preperitoneal hernia repair,TAPP)治疗腹股沟嵌顿疝的临床效果,为临床治疗腹股沟区嵌顿疝提供参考手术方式。

方法:选取青海大学附属医院腹部腔镜外科2012年11月至2014年10月腹股沟嵌顿疝患者65例,A组:20例(行腹股沟嵌顿疝腹腔镜下复位+TAPP);B组:21例(行腹股沟嵌顿疝切开复位+腹股沟疝修补术,OR);C组:24例(行腹股沟嵌顿疝切开复位+疝囊高位结扎,high ligation of hernia sac,HL)。

评价指标:三组手术时间、住院时间、术中出血量、术后疼痛发生率、术后胃肠功能恢复时间、以及并发症相关指标比较。

结果:所有患者经治疗后,均治愈出院。

(1)A组手术时间较B组、C组手术时间长(P<0.05);(2)A组住院时间、术中出血量、术后下床活动时间、术后胃肠功能恢复时间及止痛药物使用例数,与B、C组进行比较,差异均有统计学意义(P<0.05);(3)三组术后皮下血肿、腹腔感染、阴囊肿胀及切口感染指标比较,差异无统计学意义(P>0.05);(4)A 组术后复发率低于B、C组,差异有统计学意义(P<0.05);B组复发率同样低于C组,差异有统计学意义(P<0.05)。

结论:腹腔镜下经腹膜前疝无张力修补术(TAPP)术中可以充分探查腹腔,避免了遗漏坏死的肠管风险,其具有创伤小、术后恢复快、住院时间短及术后复发率低等优势,因此认为,其是治疗腹股沟嵌顿疝的一种安全、有效的术式,临床上可根据患者的实际情况适时应用。