PDF(Pubmed)
Abstract：
BACKGROUND: Abdominal wall hernia repair is among the fundamental procedures in general surgical practice. Subsequent to the advent of minimally invasive repair, there have been efforts to find the most reliable technique, with easily reproducible results that can be practiced by surgeons worldwide. From an analytical point of view, this study aimed to highlight the advantages and disadvantages of two techniques.
METHODS: A total of 60 participants were divided into two groups of 30 patients: the totally extraperitoneal (TEP) and the extended TEP (eTEP) hernia repair groups. Covariates and outcomes were analyzed using the chi-square and Mann-Whitney U tests. The study was carried out at a tertiary postgraduate teaching hospital in the western zone of Maharashtra, Pune, India, by a single surgeon. The operative procedures were as per standard surgical practice for both groups. The study was conducted to understand types of difficulties observed in the early implantation stages and the learning curve of these procedures.
RESULTS: Ten percent of the procedures in the TEP group and 6.7% of procedures in the eTEP group required Veress needle use to manage accidental pneumoperitoneum (P=0.64). The mean operative time in the eTEP group was significantly shorter than that of the TEP group (P=0.031).
CONCLUSIONS: Compared with the TEP approach, eTEP repair is associated with shorter operative times, owing to a shorter learning curve, a wider-angle view, a wider range of motion for instrument manipulation, and an ergonomically superior operative experience.
METHODS: A total of 60 participants were divided into two groups of 30 patients: the totally extraperitoneal (TEP) and the extended TEP (eTEP) hernia repair groups. Covariates and outcomes were analyzed using the chi-square and Mann-Whitney U tests. The study was carried out at a tertiary postgraduate teaching hospital in the western zone of Maharashtra, Pune, India, by a single surgeon. The operative procedures were as per standard surgical practice for both groups. The study was conducted to understand types of difficulties observed in the early implantation stages and the learning curve of these procedures.
RESULTS: Ten percent of the procedures in the TEP group and 6.7% of procedures in the eTEP group required Veress needle use to manage accidental pneumoperitoneum (P=0.64). The mean operative time in the eTEP group was significantly shorter than that of the TEP group (P=0.031).
CONCLUSIONS: Compared with the TEP approach, eTEP repair is associated with shorter operative times, owing to a shorter learning curve, a wider-angle view, a wider range of motion for instrument manipulation, and an ergonomically superior operative experience.
摘要：
背景：腹壁疝修补术是一般外科实践中的基本手术之一。在微创修复技术出现之后,一直在努力寻找最可靠的技术，具有易于重复的结果，可以由世界各地的外科医生实践。从分析的角度来看，本研究旨在强调两种技术的优缺点。
方法：将60名参与者分为两组，每组30例：完全腹膜外（TEP）和扩展TEP（eTEP）疝修补术组。使用卡方检验和Mann-WhitneyU检验分析协变量和结果。这项研究是在马哈拉施特拉邦西部地区的一所三级研究生教学医院进行的，浦那,印度,一个外科医生。两组的手术程序均符合标准手术惯例。进行该研究是为了了解在早期植入阶段观察到的困难类型以及这些程序的学习曲线。
结果：TEP组10%的手术和eTEP组6.7%的手术需要使用Verress针来处理意外气腹（P=0.64）。eTEP组的平均手术时间明显短于TEP组(P=0.031)。
结论：与TEP方法相比，eTEP修复与较短的手术时间相关，由于学习曲线较短，更宽的视角，更广泛的运动范围，用于仪器操作，和符合人体工程学的优越操作经验。
方法：将60名参与者分为两组，每组30例：完全腹膜外（TEP）和扩展TEP（eTEP）疝修补术组。使用卡方检验和Mann-WhitneyU检验分析协变量和结果。这项研究是在马哈拉施特拉邦西部地区的一所三级研究生教学医院进行的，浦那,印度,一个外科医生。两组的手术程序均符合标准手术惯例。进行该研究是为了了解在早期植入阶段观察到的困难类型以及这些程序的学习曲线。
结果：TEP组10%的手术和eTEP组6.7%的手术需要使用Verress针来处理意外气腹（P=0.64）。eTEP组的平均手术时间明显短于TEP组(P=0.031)。
结论：与TEP方法相比，eTEP修复与较短的手术时间相关，由于学习曲线较短，更宽的视角，更广泛的运动范围，用于仪器操作，和符合人体工程学的优越操作经验。
