TAPP治疗复发性腹股沟直疝合并隐匿性股疝
TAPP treatment for direct inguinal hernia combined with occult femoral hernia
杜海伟 1邵荣江 1李钦国1
作者信息
- 1. 天津中医药大学第一附属医院,国家中医针灸临床医学研究中心普外科,天津,300380
- 折叠
摘要
本病例展示了 1例复发性腹股沟直疝合并隐匿性股疝的修补手术,手术采用经腹腹膜前修补术(TAPP)修补腹壁缺损.常规在腹股沟管内环口上方切开腹膜,初步游离耻骨膀胱间隙(Retzius间隙)及腹股沟区后间隙(Bogros间隙),发现同侧隐匿性股疝,还纳疝囊后关闭耻骨上腹壁缺损,根据补片大小继续拓展Retzius间隙及Bogros间隙,内侧越过耻骨联合3 cm,下方至耻骨下3 cm,外侧达髂前上棘位置,游离上腹膜瓣,放置3D善释补片并妥善固定,缝合关闭腹膜.本手术展示了 TAPP术在清晰显露、游离间隙以及发现隐匿性疝方面的优势,证实TAPP是治疗复发性腹股沟疝的一种安全、快捷、有效术式.
Abstract
This case report presents a repair surgery for recurrent direct inguinal hernia combined with occult femoral hernia,utilizing the transabdominal preperitoneal repair(TAPP)technique to mend the abdominal wall defect.The procedure conventionally began with an incision above the internal ring of the inguinal canal to dissect the preperitoneal space,initially freeing the Retzius space and the posterior inguinal space(Bogros space).The ipsilateral occult femoral hernia was discovered,and after reducing the hernia sac,the suprapubic abdominal wall defect was closed.The Retzius and Bogros spaces were further developed according to the size of the mesh,with the medial side crossing 3 cm beyond the pubic symphysis,the lower side reaching 3 cm below the pubis,and the lateral side extending to the anterior superior iliac spine.The upper peritoneal flap was freed,a 3 D well-releasing mesh was placed and properly fixed,and the peritoneum was closed with sutures.This surgical approach not only demonstrates the advantages of the TAPP technique in clearly displaying and freeing spaces and detecting occult hernias,but also confirms that TAPP is a safe,fast,and effective procedure for treating recurrent direct inguinal hernias.
关键词
复发性腹股沟疝/腹腔镜疝修补术/隐匿性股疝Key words
recurrent direct inguinal hernia/laparoscopic hernia repair/occult femoral hernia引用本文复制引用
出版年
2024
NETL
NSTL
万方数据