一种不同的腹股沟斜疝修补技术:在腹膜前后间隙插入合成补片包裹腹膜反射:初步报告

Aydin Altan
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引用次数: 2

摘要

在大多数的腹股沟疝修补方法中,囊残端区域仍然是一个潜在的复发部位。一种不同的技术,覆盖了间接囊残端部位提出。腹股沟管后方反射前顶骨腹膜。Gilbert - I-II型腹股沟疝,切除间接囊后,切开该区域的腹膜前和腹膜后间隙。在腹壁下血管外侧的这些间隙内放置一个合成网。这种疝气的后壁是完整的。对于Gilbert III型腹股沟疝,在囊残端放置补片后使用一种组织逼近技术完成后壁修复,或者在剖开腹膜前和腹膜后间隙后用补片包裹腹股沟管中的整个腹膜反射。该技术在5例患者中应用。5例患者中,3例(Gilbert I和II)在残肢区域置入补片,2例(Gilbert III)沿整个腹膜反射置入补片。术后无血肿、疼痛等并发症,随访前无复发。该技术有效包裹腹膜反射,可预防原发性腹股沟斜疝复发,但需要大量病例进行进一步评估。关键词:腹股沟疝;间接的;修理;网
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A Different Technique of Primary Indirect Inguinal Hernia Repair by Inserting a Synthetic Mesh into the Pre and Retroperitoneal Spaces to Wrap the Peritoneal Reflection: Preliminary Report
In most methods of indirect inguinal hernia repair, the region of the sac stump remains a potential site of recurrence. A different technique that covers the site of the indirect sac stump is presented. Anterior parietal peritoneum is reflected posteriorly in the inguinal canal. In cases with Gilbert type I-II inguinal hernia, after the indirect sac is removed, the pre and retroperitoneal spaces in this region are dissected. A synthetic mesh is placed into these spaces, lateral to the inferior epigastric vessels. The posterior wall of this type hernia is intact. In cases with Gilbert type III inguinal hernia, either posterior wall repair is accomplished by using one of the tissue approximation techniques after placing a mesh in the region of the sac stump, or the entire peritoneal reflection in the inguinal canal is wrapped with a mesh after dissecting the pre and retroperitoneal spaces. This technique was performed in five patients. Of five patients, mesh was inserted on the region of stump in three (Gilbert I and II) and along the entire peritoneal reflection in two (Gilbert III). There were no postoperative complications such as seroma and pain and no recurrence till follow-up. This technique effectively wraps the peritoneal reflection and may prevent recurrences in primary indirect inguinal hernia, but it needs to be performed in a large number of cases for further evaluation. KEY WORDS : Inguinal hernia; Indirect; Repair; Mesh
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