在完全腹膜外(TEP)手术中,当套管针布置为中线配置时,由于手术角度小,手术器械很容易相互干扰。三角套管针配置,这创造了一个大的操作角度,可以最小化干扰。因此,我们评估了三角套管针配置在TEP腹股沟疝修补术中的应用.
在疝和腹壁外科的113例腹腔镜TEP腹股沟疝修补术患者中进行了一项前瞻性随机对照研究,上海市东方医院,2016年7月至2017年6月。患者被随机分配到TEP腹腔镜下三角套管针配置腹股沟疝修补术(研究组,n=59)或中线套管针配置(对照组,n=54)。围手术期结果(手术时间,手术并发症,术后疼痛,住院,和成本),术后早期并发症(血清肿/血肿和尿潴留),观察并比较中期结局(术后晚期并发症和复发)。
在平均随访10.21±2.32个月后,手术时间没有显着差异,手术并发症,术后疼痛,术后住院时间,成本,术后并发症,两组复发率。研究组间接疝囊剥离时间短于对照组。
TEP腹腔镜疝修补术中的三角形套管针配置安全可靠,是疝外科医生的一种选择。该技术可产生较大的操作角度,并避免内器械之间的干扰,这有助于TEP并减少间接疝囊解剖时间。
In totally extraperitoneal (
TEP) operation, when trocars are arranged with midline configuration, operative instruments can easily interfere with each other because of the small operative angle. The triangle trocar configuration, which creates a large operative angle, may minimize interference. Therefore, we evaluated the use of triangle trocar configuration in
TEP inguinal hernia repair.
A prospective randomized controlled study was conducted in 113 patients of laparoscopic
TEP inguinal hernia repair in the Department of Hernia and Abdominal Wall Surgery, Shanghai East Hospital, between July 2016 and June 2017. Patients were randomly assigned to
TEP laparoscopic inguinal hernioplasty with triangle trocar configuration (study group, n = 59) or midline trocar configuration (control group, n = 54). Perioperative outcomes (operative time, operative complications, postoperative pain, hospital stay, and costs), early postoperative complications (seroma/hematoma and uroschesis), and mid-term outcomes (late postoperative complications and recurrence) were observed and compared.
After a mean follow-up of 10.21 ± 2.32 mo, there was no significant difference in operative time, operative complications, postoperative pain, postoperative hospital stay, costs, postoperative complications, and recurrence rate between the two groups. The indirect hernia sac dissection time was shorter in the study group than in the control group.
Triangle trocar configuration in TEP laparoscopic hernia repair is safe and reliable and is an option for hernia surgeons. The technique creates a large operative angle and avoids interference between endo-instruments, which facilitates
TEP and decreases the indirect hernia sac dissection time.