摘要
目的:探讨女性腹股沟疝患者行腹腔镜下经腹腔腹膜前疝修补术(transabdominal preperitoneal,TAPP)中子宫圆韧带腹壁化的理想处理方法。方法:回顾分析2011年11月1日至2013年5月31日为14例女性患者行TAPP的临床资料及手术录像,重点关注手术操作过程中子宫圆韧带的处理。其中腹股沟斜疝12例,直疝1例,1例斜疝合并直疝。结果:14例手术均顺利完成,手术时间平均(51.1±18.4)min,术后患者恢复理想。子宫圆韧带的处理:剥离1例,横断2例,沿其两侧纵行劈开腹膜游离11例。后者操作简便,可保证子宫圆韧带及腹膜的完整性。术后随访,无复发及慢性疼痛发生。结论:沿子宫圆韧带纵向劈开腹膜,自腹膜完整分离子宫圆韧带,实现腹壁化,较剥离及横断技术具有明显的优越性,其临床实用性强、学习曲线短,临床应用前景及推广价值较高。
Objective ： This study aims at identifying an optimal surgical technique for perietalization of round ligament of uterus in female transabdominal preperitoneal （TAPP） cases. Methods：Medical record and operation videos of female TAPP cases in depart- ment of general surgery, Qilu Hospital of Shandong University between Nov. 1 st 2011 and May 31st 2013 were reviewed retrospectively, clinical data were collected. Particular attention was paid to the procedure of perietalization of round ligament of uterus. A total of 14 fe- male TAPP cases were selected,which included 12 cases of indirect inguinal hernia, 1 direct inguinal hernia, 1 patient presented both indirect and direct inguinal hernia. Results：The average duration of operation was （51.1 _＋ 18.4 ） min, recovery of patients was une- ventful. The techniques applied in the perietalization of round ligament of uterus were as follows ： 1 dissection the round ligament from peritoneum ,2 cut off and 11 incision the peritoneum along the longitudinal axis of round ligament. The latter technique had advantage in easy procedure, keeping integrity of round ligament and peritoneum. The operation procedures of all patients were successful and no post-operative complications were found such as recurrence and chronic pain in follow-up. Conclusions：With regard to strong clinical practicability and short learning curve, superiority of technique of dissecting the peritoneum along the longitudinal axis of round ligament of uterus is obvious compared with dissection and cutting off. The prospect of clinical application and popularization is satisfying.
出处
《腹腔镜外科杂志》
2013年第10期721-724,共4页
Journal of Laparoscopic Surgery
关键词
疝
腹股沟
经腹腔腹膜前疝修补术
腹腔镜检查
子宫圆韧带
腹壁化
Hernia, inguinal
Transabdominal preperitoneal
Laparoscopy
Round ligament of uterus
Perietalization
