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首页> 外文期刊>Advances in Surgical Sciences >A New Open Minimal Access Approach for Mesh Repair of Inguinal Hernia
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A New Open Minimal Access Approach for Mesh Repair of Inguinal Hernia

机译：腹股沟疝滤网修补的一种新的开放式最小通路方法

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Mesh repair of inguinal hernia by open surgery is traditionally done with an oblique inguinal incision of 4-5 cm and by opening the inguinal canal by incising external oblique aponeurosis. We are presenting a new technique for mesh repair of inguinal hernia with two mini incisions, one over the superficial, and another over deep inguinal ring and without incising the external oblique aponeurosis. Methods: The study group comprised of 104 males patients undergoing surgery for inguinal hernia during the period January 2010-January 2015. Data regarding patient demographics, type of anesthesia given, operation performed, and complications were recorded. The operation was carried out under spinal or epidural anesthesia. With a transverse incision of size 1-1.5 cm at the superficial inguinal ring, the cord structures were reached and lifted up with the finger,. By passing an artery forceps with the tip upwards under neath the external oblique aponeurosis, another incision of 1-1.5cm was made at the deep inguinal ring and the cord was lifted up by mobilizing. The indirect sac was dissected, ligated and mesh was sutured to the inguinal ligament by interrupted sutures and on the other side to conjoined tendon by retracting wound. The patients were followed up in the post-operative period. Results: There were 104 men with an age range of 20-64 years (mean35.6). On examination, 84 patients had indirect inguinal hernia and 20 patients had direct hernia. The incision size at superficial ring and deep rings measured at the end of the operation was 1.4cm, (range1.2-2cm). Through the incision at the deep inguinal ring, the indirect sac could be identified, transfixation, ligation and excision of sac was done without difficulty. The mesh could be easily passed underneath the external oblique, spread and sutured. 3- sutures could be applied by retracting the external oblique. No drain was required in any repair. The mean operation rime was 54 minutes (range50-62 minutes). There was no post-operative hematoma or scrotal edema in any of the patients. During a mean follow-up period of 48 months (range 12-60 months,), there was no recurrence and one patient had chronic pain. Conclusion: Inguinal hernia mesh repair with two mini incisions, one over the superficial inguinal ring and one over the deep inguinal ring and without incising the external oblique aponeurosis gives adequate exposure to place the mesh and repair the hernia. Follow- up did not show any recurrence or or significant chronic pain.
机译：传统上，通过开腹手术通过4-5 cm的腹股沟斜切口和通过切开外斜腱膜来打开腹股沟管来完成腹股沟疝的网状修复。我们提出了一种新的腹股沟疝的网状修复技术，该技术有两个小切口，一个在浅表层，另一个在深腹股沟环上，并且不切开外斜肌腱膜。方法：研究组由104名在2010年1月至2015年1月期间接受腹股沟疝手术的男性患者组成。记录了有关患者人口统计学，给予的麻醉类型，手术方式和并发症的数据。该手术是在脊髓或硬膜外麻醉下进行的。在腹股沟浅环处用大小为1-1.5 cm的横向切口，达到脐带结构并用手指提起。通过使动脉钳的尖端向上朝外斜肌腱膜下方，在腹股沟深环处再做一个1-1.5cm的切口，并通过动员将脐带提起。切开间接囊，结扎，并用间断缝线将网眼缝合到腹股沟韧带上，另一侧通过缩回伤口将其缝合到肌腱上。术后随访。结果：共有104名男性，年龄范围为20-64岁（平均35.6）。检查时，有84例患有间接腹股沟疝，而20例患有直接疝。手术结束时测量的浅环和深环切口尺寸为1.4厘米（范围1.2-2厘米）。通过腹股沟深处的切口，可以识别出间接囊，囊的固定，结扎和切除很容易。网格可以很容易地从外部斜线下方穿过，展开和缝合。 3缝线可通过缩回外部斜线来应用。任何维修都不需要排水。平均手术时间为54分钟（范围为50-62分钟）。任何患者均无术后血肿或阴囊水肿。在平均48个月（12-60个月）的随访期间，没有复发，一名患者患有慢性疼痛。结论：腹股沟疝网修补术有两个小切口，一个在浅腹股沟环上，一个在深腹股沟环上，并且不切开外斜肌腱膜，可以充分暴露以放置网孔并修复疝气。随访未发现任何复发或明显的慢性疼痛。

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