【摘要】 目的评估一种使用长针头和普理灵线即可完成的经腹白线穿刺假疝囊固定方法的可行性和有效性。方法选择2017年11月至2019年3月,中山大学附属第五医院接受腹腔镜完全腹膜外疝修补术或腹腔镜经腹腹膜前疝修补术手术并被纳入本研究腹股沟疝患者45例。完成疝囊分离后,放置补片之前,在耻骨联合上方2～4cm的位置,经腹白线穿刺置入长针头半环状套线并穿刺入假疝囊,退出针头后于同一穿刺点经不同针道再次置入长针头及套线,穿过原半环状套线,退出针头,将第1次半环状套线抽出,同时带出第2次线头,收紧并打结固定于皮下,完成直疝假疝囊固定。结果本组45例腹股沟疝患者56侧假疝囊固定均取得成功。平均单次操作时间为2.6 min。术中或术后未发生重大不良事件。所有患者平均2.3 d后出院。随访期间2例患者出现血清肿,术后无复发。结论经腹白线穿刺处理腹股沟直疝假疝囊是一种简单、有效、安全的方法。更多还原

【Abstract】 Objective To assess the efficacy and feasibility of a new and simplified method for transversalis fascia(TF) fixation via linea alba puncture, which can be accomplished with a long needle and a Prolene line. Methods 45 patients with inguinal hernia who underwent totally extraperitoneal hernioplasty(TEP) or transabdominal preperitoneal hernioplasty(TAPP) from November 2017 to March 2019, were enrolled in this study. After the separation of the hernia sac, a long needle with semi-circular Prolene line was inserted through the linea alba, 2 to 4 cm above the pubic symphysis, then punctured into the lax TF. The long needle with line was inserted again at the same point but different path, the second line should pass through the first semi-circular line, withdrawing the needle, pulling out the first semi-circular line in order to pull the second line out, tightening and binding. Fixation of the lax TF was performed subcutaneously. Results 56 lax TF was successfully fixed in 45 cases of inguinal hernia. The average operation time was 2.6 minutes. No major adverse events occurred during or after operation. All patients were discharged after an average of 2.3 days. During the follow-up period, post-operative seroma occurred in 2 patients and no recurrence observed. Conclusion Puncture through the linea alba for the treatment of the lax TF is a simple, effective and safe method.更多还原