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首页> 外文期刊>Surgical Endoscopy >Missed lipoma of the spermatic cord. A pitfall of transabdominal preperitoneal laparoscopic hernia repair.
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Missed lipoma of the spermatic cord. A pitfall of transabdominal preperitoneal laparoscopic hernia repair.

机译：遗失的精索脂肪瘤。腹腔镜腹腔镜疝修补术的一个陷阱。

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摘要

BACKGROUND: Missed lipoma of the spermatic cord is a pitfall unique to the transabdominal preperitoneal (TAPP) laparoscopic hernia repair. This problem occurs when a palpable inguinal mass is noted preoperatively, but no identifiable hernia defect is found at time of laparoscopy and the procedure is terminated. METHODS: Our group encountered six patients without intraperitoneal defects that had large cord lipomas on preperitoneal exploration. Two of these patients had undergone previous intraabdominal laparoscopy for a proposed TAPP repair, which was aborted when no defect was seen. RESULTS: Both patients were referred for continued symptomatic groin masses, which were subsequently treated by lipoma resection in conjunction with inguinal floor repair. CONCLUSIONS: When patients present with a groin mass, exploration of the preperitoneal space and cord structures is indicated during TAPP repair, even in the presence of a normal-appearing abdominal floor. Abandoning a transabdominal approach without exploration of the preperitoneal structures may lead to a failure to identify symptomatic and/or palpable cord lipomas.
机译：背景：精索丢失的脂肪瘤是腹腔镜腹膜镜疝修补术特有的陷阱。术前注意可触知的腹股沟肿块，但在腹腔镜检查时未发现明显的疝气缺损并终止手术时，会发生此问题。方法：我们小组遇到了6例无腹膜内缺损的患者，这些患者在腹膜前探查时有大的脐带脂肪瘤。这些患者中有两个曾接受过腹腔镜腹膜镜检查以进行拟议的TAPP修复，但在未见任何缺陷的情况下被中止。结果：两名患者均因持续症状性腹股沟肿块而被转诊，随后通过脂肪瘤切除结合腹股沟底修补术进行治疗。结论：当患者出现腹股沟肿块时，即使在腹部正常出现的情况下，在TAPP修复过程中仍需探查腹膜前间隙和脐带结构。放弃经腹途径而不探索腹膜前结构可能导致无法识别症状性和/或可触知的脐带脂肪瘤。

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