Laparoscopic Extraperitoneal Inguinal Hernia Repair with Low-pressure Pneumoperitoneum without Using Stapling Devices: Report of 38 Cases
- VernacularTitle:低气腹压免钉合器固定腹腔镜腹膜外腹股沟疝修补术(附38例报告)
- Author:
Lixin ZOU
;
Jinchang WU
;
Feng HONG
- Publication Type:Journal Article
- Keywords:
Laparoscope;
Reducible inguinal hernia;
Herniorrhaphy
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and effectiveness of laparoscopic extraperitoneal inguinal hernia repair with low-pressure pneumoperitoneum without using stapling devices.Methods A total of 38 patients with reducible inguinal hernia underwent laparoscopic extraperitoneal inguinal hernia repair in our hospital from January 2006 to February 2007.Three abdominal trocars were introduced into the extraperitoneal cavity.An 11-mm trocar was placed at the lower border of the umbilicus,and the other two sized 5.5 mm were at the upper and lower 1/3 of the line between the umbilicus and the pubic symphysis,respectively.Then,low-pressure(6-8 mm Hg) CO2 was insufflated into the extraperitoneal cavity.Non-traumatic forceps was used to create an operative space from the hilum to the pubic symphysis and the diseased inguinal area.The hernia sac and the fabrics around it were disconnected.For big hernia sacs,the sac was ligated,cut at the cervix,and then left at its original site.While for small hernia sacs,it was dissociated and put back into the abdominal cavity.Afterwards,a patch sized 12 cm ? 15 cm was placed into the cavity,stretched,and attached to the abdominal wall,covering the annulus inguinalis profundus,Hesselbach triangle,and the femoral ring,without using stapling devices.After the operation,the patients received sandbag compression at the operative area and were kept in bed with urethral catheter for 24 hours. Results The operation was successfully accomplished in all the 38 cases without conversion to open surgery.The operation time was 45-85 min(mean,56 min).The intraoperative blood loss was 5-10 ml.After the operation,seroma occurred in 4 cases,and perforation in 2.No subcutaneous emphysema,hypercapnia,intestinal injury,neuralgia,or hemorrhage was found.The patients were followed up for 6 to 19 months(mean,10.5 months),and no recurrence occurred.Conclusions It is feasible to use laparoscopic extraperitoneal inguinal hernia repair with low-pressure pneumoperitoneum without using stapling devices.The method is associated with few complications and confirmed efficacy.
