Abstract: Laparoscopic transabdominal preperitoneal approach for giant inguinal hernias：A report of 5 cases        LI Ying-ru, GAN Wen-chang, ZENG Bing, et al. Department of Gastroenterology, Hernia and Abdominal Wall Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou510655, China
Corresponding author: CHEN Shuang，E-mail：sysusc@126.com
Abstract    Objective    To explore the clinical value of laparoscopic treatment of giant scrotal hernia. Methods    The clinical data of 5 patients with giant scrotal hernia from July 2016 to July 2018 in the Sixth Affiliated Hospital, Sun Yat-sen University were analyzed retrospectively, which included preoperative preparation, intraoperative conditions, postoperative management, postoperative complications and follow-up. Results    All patients underwent transabdominal preperitoneal prosthetic(TAPP) with a median operation time of 85 minutes and a median postoperative hospital stay of 5 days. All patients were placed with a scrotal drainage tube  and removed within 48 hours after surgery. There were two patients with seroma, which both improved after conservative treatment. More than 12 to 29 months of follow-up, there is no recurrence and chronic pain. Conclusion    Laparoscopic treatment of giant scrotal hernia is feasible, but it is necessary to scientifically screen suitable patients, strictly  prepare for surgery, intraoperative management and postoperative care to reduce the incidence of postoperative complications.

Key words: giant inguinal hernia, hernia repair, laparoscope, abdominal compartment syndrome

摘要：

目的    探讨腹腔镜治疗巨大阴囊疝的临床应用价值。方法    回顾分析2016年7月至2018年7月中山大学附属第六医院腹腔镜经腹腹膜前修补术（TAPP）的5例巨大阴囊疝的病例临床资料，观察术前准备、术中情况、术后处理、术后并发症以及随访情况。结果    所有病人均行腹腔镜TAPP，中位手术时间为85 min，术后中位住院时间为5 d。所有病人均在术中放置阴囊引流管，术后48 h内拔除。有2例病人出现血清肿，保守治疗后好转。术后随访12～29个月，无复发及慢性疼痛病例。结论    巨大阴囊疝通过腹腔镜治疗是可行的，但要科学筛选适应证，严格做好术前准备、术中处理以及术后护理，减少术后并发症的发生。

关键词: 巨大阴囊疝, 疝修补术, 腹腔镜, 腹腔筋膜室综合征