PDF(Pubmed)
Abstract：
BACKGROUND: Laparoscopic Total Extra-peritoneal Inguinal Hernia Repair(TEP) presents escalated risks of surgical complications, notably bleeding, particularly in European Hernia Society (EHS) types 3 and recurrent inguinal hernia. In this study, we introduced an innovative technique using indocyanine green-labeled fluorescence laparoscopy to mitigate intraoperative complications, including bleeding and rupture of the hernial sac.
METHODS: This retrospective study reviewed records of 17 patients who underwent TEP repair at Anqing Municipal Hospital between July and August 2023. Intraoperatively, fluorescence imaging was utilized to trace the pathway of the spermatic vessels and outline the boundaries of the hernia sac to facilitate a thorough dissection.
RESULTS: The procedure was successfully completed in all 17 patients, with a median operation time of 42 min (range: 30-51 min). Median intraoperative blood loss was 5 ml (range: 3-8 ml). Complete dissection of the hernia sac was achieved in each case without any incidents of sac rupture. Hemodynamic parameters of blood flow within the spermatic artery on postoperative day 1 showed no statistically significant deviations from the preoperative values. Furthermore, during the 7-month follow-up period, there were no cases of seroma formation or hernia recurrence.
CONCLUSIONS: Our findings suggest that employing indocyanine green-labeled fluorescence technology in TEP repair significantly reduces intraoperative complications, notably bleeding and rupture of the hernial sac. This technique demonstrated a negligible impact on the hemodynamic parameters of the spermatic artery and reduced the overall surgical time.
METHODS: This retrospective study reviewed records of 17 patients who underwent TEP repair at Anqing Municipal Hospital between July and August 2023. Intraoperatively, fluorescence imaging was utilized to trace the pathway of the spermatic vessels and outline the boundaries of the hernia sac to facilitate a thorough dissection.
RESULTS: The procedure was successfully completed in all 17 patients, with a median operation time of 42 min (range: 30-51 min). Median intraoperative blood loss was 5 ml (range: 3-8 ml). Complete dissection of the hernia sac was achieved in each case without any incidents of sac rupture. Hemodynamic parameters of blood flow within the spermatic artery on postoperative day 1 showed no statistically significant deviations from the preoperative values. Furthermore, during the 7-month follow-up period, there were no cases of seroma formation or hernia recurrence.
CONCLUSIONS: Our findings suggest that employing indocyanine green-labeled fluorescence technology in TEP repair significantly reduces intraoperative complications, notably bleeding and rupture of the hernial sac. This technique demonstrated a negligible impact on the hemodynamic parameters of the spermatic artery and reduced the overall surgical time.
摘要：
背景：腹腔镜全腹膜外腹股沟疝修补术（TEP）存在手术并发症的风险，尤其是出血,特别是在欧洲疝协会（EHS）3型和复发性腹股沟疝。在这项研究中,我们引入了一种创新技术，使用吲哚菁绿标记的荧光腹腔镜检查来减轻术中并发症，包括疝囊出血和破裂.
方法：这项回顾性研究回顾了2023年7月至8月在安庆市医院接受TEP修复的17例患者的记录。术中,荧光成像用于追踪精索血管的路径并勾勒出疝囊的边界，以促进彻底的解剖。
结果：17例患者均顺利完成手术，中位手术时间为42分钟（范围：30-51分钟）。术中出血量中位数为5ml（范围：3-8ml）。在每种情况下都实现了疝囊的完全解剖，没有任何囊破裂的事件。术后第1天精索动脉血流的血流动力学参数与术前值无统计学差异。此外，在7个月的随访期间，无血清肿形成或疝复发病例。
结论：我们的研究结果表明，在TEP修复中采用吲哚菁绿标记的荧光技术可显著减少术中并发症，明显出血和疝囊破裂。该技术对精索动脉的血液动力学参数的影响可忽略不计，并减少了整体手术时间。
方法：这项回顾性研究回顾了2023年7月至8月在安庆市医院接受TEP修复的17例患者的记录。术中,荧光成像用于追踪精索血管的路径并勾勒出疝囊的边界，以促进彻底的解剖。
结果：17例患者均顺利完成手术，中位手术时间为42分钟（范围：30-51分钟）。术中出血量中位数为5ml（范围：3-8ml）。在每种情况下都实现了疝囊的完全解剖，没有任何囊破裂的事件。术后第1天精索动脉血流的血流动力学参数与术前值无统计学差异。此外，在7个月的随访期间，无血清肿形成或疝复发病例。
结论：我们的研究结果表明，在TEP修复中采用吲哚菁绿标记的荧光技术可显著减少术中并发症，明显出血和疝囊破裂。该技术对精索动脉的血液动力学参数的影响可忽略不计，并减少了整体手术时间。
