Abstract:

Laparoscopic repair of suprapubic ventral hernias: A study of 56 patients        FEI Yang，SUN Peng-jun，LI Ji-ye. Therapeutic and Research Center of Hernias and Abdominal Wall Diseases，Department of General Surgery，the First Affiliated Hospital of the PLA General Hospital，Beijing 100048，China
Corresponding author：LI Ji-ye，E-mail：jiye151015@163.com
Abstract    Objective    To explore laparoscopic repair technique and therapeutic effect for suprapubic ventral hernias. Methods    The clinical data of 56 patients underwent laparoscopic repair for suprapubic ventral hernia in Department of General Surgery，the First Affiliated Hospital of the PLA General Hospital were analyzed retrospectively. All of the operative techniques included dissection into the space of Retzius to mobilize the bladder，closure of myofascial defect with nonabsorbable prolene sutures, intraperitoneal onlay of mesh using a composite mesh, transfascial suture fixation of the mesh, and protack fixation to the pubic bone and Cooper’s ligaments. Results    A total of 55 patients underwent laparoscopic repair procedures，except for 1 conversion to open repair due to severe adhesion in pelvis. Average defect size was （30.3±12.5）cm2 and average mesh size was （96.7±28.3）cm2. The postoperative hospital stay was （4.5±1.5）days. There were 8 patients with perioperative complications（14.3%），including bladder injury （n=1），bowel injury （n=3），inferior epigastric vessels bleeding (n=1)( all of them were treated by laparoscopy), postoperative seroma formation （n=2），chronic pain (n=1)(all of them were cured by conservative ways). A total of 55 patients were followed up for （25.8±13.2）months，and just 1 patient recurred. Conclusion    The laparoscopic repair technique is an ideal procedure for suprapubic hernias with good clinical results.

Key words: laparoscopy, suprapubic hernia, incisional hernia

摘要：

目的    探讨腹腔镜耻骨上疝修补手术技术及临床疗效。方法    回顾性分析2008年6月至2014年6月中国人民解放军总医院第一附属医院普外科收治的56例耻骨上切口疝病人的临床资料。均游离膀胱腹膜瓣、关闭肌筋膜缺损、放置复合补片并行贯穿腹壁的缝合固定，采用螺旋钉固定耻骨联合后方、双侧Cooper韧带。结果    55例病人顺利完成腹腔镜修补手术，仅1例因盆腔致密粘连而中转开放手术。术中测量疝环面积为（30.3±12.5）cm2，所用复合补片面积为（96.7±28.3）cm2。手术时间（66.4±35.5）min，术后住院（4.5±1.5）d。围手术期发生并发症8例（14.3%），其中膀胱破损1例，小肠浆肌层膜破损3例，术中腹壁下动脉损伤出血1例，均行腹腔镜手术处理；术后血清肿2例，慢性疼痛1例，均经保守治疗治愈。55例病人获得随访，随访时间（25.8±13.2）个月，仅1例病人复发。结论    腹腔镜耻骨上疝修补疗效良好。

关键词: 腹腔镜, 耻骨上疝, 切口疝