Abstract:

Discussion of laparoscopic transabdominal preperitoneal prosthetics in the treatment of recurrent inguinal hernia           WANG Ming-gang. Department of Hernia and Abdominal Wall Surgery, Chaoyang Hospital of Capital Medical University，Beijing 100043, China
Abstract    The treatment of recurrent hernia after inguinal operation especially tension-free repair has been a difficult problem that hernia surgeons must face. Laparoscopic technique has been accepted and used gradually by surgeons with the advantages of retroperitoneal approach and direct vision. At present，there has been not yet a normalized operation manual and guideline of laparoscopic technique in the treatment of recurrent hernia because of the complex situation. The preperitoneal space could be gotten with TAPP completely in most cases; some could cut the peritoneum with shuttle or T-type incisions. There is no need to move the previous mesh and could relax restrictions appropriately in fixing mesh. In some particular cases, surgeons could repair defects with local repairing，intraperitoneal onlay mesh (IPOM) or transabdominal partial extraperitoneal （TAPE）.

Key words: inguinal hernia, recurrent hernia, transabdominal preperitoneal prosthetics（TAPP）

摘要：

复发性腹股沟疝尤其是无张力疝修补术后复发疝的治疗依然是疝外科医师必须面对的难题。腹腔镜疝修补术凭借其“后入路”的手术特点和直视下操作的技术优势逐渐成为处理开放手术后复发疝的优选术式而被外科医师所接受和应用。因为复发疝情况复杂多变，目前尚无规范化的复发疝腹腔镜手术操作规范和指南。应用腹腔镜经腹腹膜前修补术（TAPP）治疗复发疝时绝大多数病人可以完整游离腹膜前间隙，部分病人须选择梭形或“T”形切口切开腹膜。原有补片一般不建议去除，在补片固定方面建议适当放宽指征，在特殊情况下可以选择局部修补法、腹腔内补片植入术（IPOM）或经腹部分腹膜外修补术（TAPE）修补缺损。

关键词: 腹股沟疝, 复发疝, 经腹腹膜前补片植入术