Objective: To explore the feasibility of single-incision laparoscopic totally extraperitoneal hernioplasty (SILS-TEP) with self-made port for repairing of inguinal hernia.
Methods: SILS-TEP was performed in 7 inguinal hernia patients (9 sides) with conventional laparoscopic instruments and self-made port, which composed of a wound retractor, surgical gloves and 3 ordinary trocars. The clinical data and follow-up results of 7 cases were retrospectively collected and analyzed.
Results: The self-made port was applied for SILS-TEP uneventfully without the need of additional ports in all 7 patients (9 inguinal hernias). The median operating time was 90. 0 (70-125) min, intraoperative blood loss was 10. 0 (5. 0-20. 0) mL and postoperative hospital stay was 2.0 (2. 0-4. 0) d. The median pain scores of visual analog scale (VAS) at 6 h,12 h, 24 h and 14 d were 3(2~4), 2(1~2), 1(0~2) and 0(0~1), respectively. There were no intraoperative complications reported, and all patients were satisfied with wound healing. No hernia recurrence was observed during the 3-months of follow-up.
Conclusion: Our initial experiences show that SILS-TEP with self-made port is a safe and feasible surgery, which can simplify the procedure with available equipments and reduce the cost, therefore can be applied in grass-root hospitals.
目的: 探讨采用自制简易单孔器行单孔腹腔镜全腹膜外腹股沟疝修补术(SILS-TEP术)的安全性和可行性。
方法: 病例来自2013年2~4月浙江大学医学院附属邵逸夫医院普外科。采用一次性切口牵开固定器、无菌手套和普通腹腔镜套管制成简易单孔器, 使用常规腹腔镜器械对7例腹股沟疝患者行SILS-TEP术, 总结患者的临床资料和随访结果。
结果: 全部7例(9侧)腹股沟疝患者均行SILS-TEP术成功, 中位手术时间90.0(70~125) min, 中位出血量10.0(5.0~20.0) mL, 中位住院天数2.0(2.0~4.0) d, 术后患者疼痛轻微, 无围手术期并发症。随访3个月切口愈合佳, 均无复发及其他并发症发生。
结论: 采用自制简易单孔器行SILS-TEP术初步经验显示安全可行, 该方法能简化单孔手术器械, 减轻患者经济负担, 易于基层医院推广应用。