Abstract:

Controversies and challenges of laparoscopic surgery for incarcerated inguinal hernia        ZHANG Chen-bo，LI Jian-wen. Department of General Surgery，Rui Jin 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    Both controversies and challenges exist in the application of laparoscopic techniques for incarcerated inguinal hernias. The main controversy is whether the mesh could be used where pollution might exist. Studies have revealed that the rates of incision infection and mesh infection doesn’t increase significantly in laparoscopic treatment of incarcerated hernia. Moreover，bowel viability and blood supply can be better observed during the whole time of procedure in such method. Careful preoperative evaluation，reasonable choice of surgical approach，correct mesh use and skilled laparoscopic hernia repair skills are the guarantee for the success of laparoscopic operation. Further evaluation is still needed and should be supported by more large data and evidence-based studies.

Key words: laparoscopy, inguinal hernia, incarceration

摘要：

腹腔镜技术治疗腹股沟嵌顿疝争议和挑战并存。争议主要体现在污染的情况下是否可以使用补片。有证据显示，腹腔镜技术治疗嵌顿疝时可全程观察嵌顿内容物的血运及活力，且其切口、补片感染的发生率并未明显增加。谨慎的术前评估、合理的术式选择、正确的补片使用以及熟练的腹腔镜疝修补技能等因素是腹腔镜手术成功的保障。进一步的评价有待于更多大数据和循证医学证据的支持。

关键词: 腹腔镜, 腹股沟疝, 嵌顿