中国实用外科杂志

中国实用外科杂志

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腹股沟疝无张力修补术术式演变与合理选择

李健文，乐    飞   

  1. 上海交通大学医学院附属瑞金医院普外科，上海市微创外科临床医学中心，上海 200025
  • 出版日期:2017-11-01 发布日期:2017-11-01

  • Online:2017-11-01 Published:2017-11-01

摘要：

腹股沟疝无张力修补术可分为腹横筋膜前的前层修补和腹横筋膜后的后层修补。前者主要包括平片修补术和网塞平片术，平片用于修补腹股沟管后壁，网塞用于疝局部缺损的加强修补。后者主要包括各类腹膜前修补术，修补原理是加强肌耻骨孔。腹腔镜腹股沟疝修补术的本质是腹膜前修补术，特点是利用腹腔镜器械、通过后入路、在图像放大的直视下进行手术。经腹腔腹膜前疝修补术（TAPP）和完全腹膜外疝修补术（TEP）是腹腔镜腹股沟疝修补术的两种主要术式，选择主要取决于医生的经验和病人的情况。

关键词: 腹股沟疝, 腹腔镜, 无张力疝修补术, 补片

Abstract:

Appropriate selection of tension-free inguinal hernia repair procedures        LI Jian-wen，YUE Fei. Department of General Surgery，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine；Shanghai Clinical Minimally Invasive Surgery Center，Shanghai 200025，China
Corresponding author: LI Jian-wen，E-mail：ljw5@yeah.net
Abstract    The tension-free hernioplasty for inguinal hernia consists of anterior and posterior repair. Anterior repair includes plain mesh repair as well as plug and patch repair. Plain mesh reinforces the posterior wall of inguinal box, while plug could reinforce local defect. Posterior repair includes various preperitoneal repairs based on the principle of myopectineal orifice reinforcement. Laparoscopic hernia repair applies laparoscopic instruments via posterior approach to accomplish posterior repair under direct vision. Both TAPP and TEP are major procedures for inguinal hernia repair. The selection of appropriate procedure depends on surgeons’ experiences and patients’ situation.

Key words: inguinal hernia, laparoscope, tension-free hernia repair, mesh