预防机器人辅助经腹腹膜前修复术后并发症:临床一例

D. M. Sharafutdinov, R. R. Shavaleev, I. Kabirov, V. Pavlov
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引用次数: 0

摘要

介绍腹股沟疝修补术是目前最常见的选择性手术之一。在我们的诊所,大多数腹股沟疝修补术都是通过腹腔镜进行的。经腹腹膜前腹股沟疝修补术后最常见的并发症是术后浆膜瘤。材料和方法。一位患有右侧腹股沟疝的35岁患者C.在我们诊所寻求医疗护理。他接受了机器人辅助TAPP和吲哚菁绿荧光淋巴造影术。结果和讨论。本文描述了机器人辅助经腹腹膜前腹股沟疝修补术引起的精索内淋巴管损伤与腹股沟浆膜瘤术后发展之间的可能关系。将5mg/ml吲哚青绿注射到疝突一侧的睾丸中,以观察淋巴管。在这种情况下,这种程序是安全可行的。由于疝囊与两条可见的淋巴管紧密融合,因此在手术中将其切除。在术后早期,超声扫描显示腹股沟区有一个约10毫升的亚临床血清瘤。结论:在机器人辅助TAPP过程中,应进一步进行一系列ICG荧光淋巴造影,以阐明淋巴管损伤与鞘膜积液之间的关系。
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Preventing postoperative complications after robot-assisted transabdominal preperetoneal repair: clinical case
Introduction. Inguinal hernia repair is one of the most common elective surgeries today. In our clinic, the majority of inguinal hernia repairs are performed laparoscopically. The most frequent complication after transabdominal preperitoneal inguinal hernia repair is postoperative seroma.Materials and methods. A 35-year-old patient C. with a right-sided inguinal hernia sought medical care in our clinic. He underwent robot-assisted TAPP with fluorescence lymphography using indocyanine green (ICG).Results and discussion. The present paper describes the possible relationship between intraoperative damage of the lymphatic vessels within the spermatic cord induced by robot-assisted transabdominal preperitoneal inguinal hernia repair and postoperative development of inguinal seroma. 5 mg/ml of indocyanine green was injected into the testicle on the side with the hernial bulge to visualize the lymphatic vessels. In this case such procedure is safe and feasible. Due to the tight fusion of the hernia sac with two visualized lymphatic vessels, they were excised during surgery. In the early postoperative period, an ultrasound scan revealed a subclinical seroma in the inguinal region of approximately 10 ml.Conclusion. A case series of ICG fluorescence lymphography during robot-assisted TAPP should be performed further to elucidate the relationship between lymphatic vessel damage and hydrocele.
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