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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 36 -38. doi: 10.3877/cma.j.issn.1674-392X.2019.01.010

所属专题： 文献；

论著

直接穿刺法建立第一穿刺孔及气腹在腹腔镜切口疝修补术中的应用
李骥宇1, 崔明2,†(), 刘泽刚2, 陈英1, 冯梅2   
  1. 1. 650032　昆明，中国人民解放军联勤保障部队920医院普通外科；650032　昆明，昆明医科大学成都军区昆明总医院临床学院
    2. 650032　昆明，中国人民解放军联勤保障部队920医院普通外科
  • 收稿日期:2018-05-06 出版日期:2019-02-18
  • 通信作者: 崔明

Application of creating first trocar andpneumoperitoneum withdirect trocatin Laparoscopic incisional herniarepair

Jiyu Li1, Ming Cui2,†(), Zegang Liu2, Ying Chen1, Mei Feng2   

  1. 1. Department of General Surgery, 920 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Kunming 650032, China; Kunming General Hospital of Chengdu Military Command of Kunming Medical University, Kunming 650031, China
    2. Department of General Surgery, 920 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Kunming 650032, China
  • Received:2018-05-06 Published:2019-02-18
  • Corresponding author: Ming Cui
  • About author:
    Corresponding author: Cui Ming, Email:
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引用本文：

李骥宇, 崔明, 刘泽刚, 陈英, 冯梅. 直接穿刺法建立第一穿刺孔及气腹在腹腔镜切口疝修补术中的应用[J]. 中华疝和腹壁外科杂志(电子版), 2019, 13(01): 36-38.

Jiyu Li, Ming Cui, Zegang Liu, Ying Chen, Mei Feng. Application of creating first trocar andpneumoperitoneum withdirect trocatin Laparoscopic incisional herniarepair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(01): 36-38.

目的

探讨腹腔镜切口疝修补术建立第一穿刺孔及气腹的临床经验。

方法

回顾性分析2009年1月至2016年12月，中国人民解放军联勤保障部队920医院48例接受腹腔镜切口疝修补术患者的临床资料。

结果

本组患者除4例中转外，其余患者均顺利完成手术。本组患者平均手术时间（157±90）min，术中平均出血（112±33）ml，术后平均住院时间（23±18）d。1例患者术后出现肠瘘，经保守治疗后治愈；另1例患者因肠粘连致肠梗阻，予以手术治疗后治愈。复发患者1例，再次于腹腔镜下修补，后患者无复发。本组患者建立第一穿刺孔及气腹过程中偶有腹壁血管损伤，无腹腔内肠管及重要血管损伤，术后无血清肿、慢性疼痛等。

结论

无损伤可视套管直穿在腹腔镜切口疝修补术中建立第一穿刺孔及气腹比较安全、可靠。

关键词: 切口疝, 直接穿刺法, 气腹, 腹腔镜
Objective

To discuss the clinical experience of creating first trocar with direct trocar in laparoscopic incisional hernia repair.

Methods

The clinical data of 48 patients undergoing laparoscopic incisional hernia repair from January 2009 to December 2016 were retrospectively analyzed.

Results

In this series, 4 patients needed to convert to laparotomy, the remaining patients were successfully completed surgery. The average operation time of the group was (157±90) minutes, the average bleeding was (112±33) mL, and the mean duration of the patients' stay in hospital was (23±18) days after operation. Another one patient had intestinal fistula after operation and was cured after conservative treatment. The other one patient with intestinal obstruction which was caused by intestinal adhesion, was cured by surgical treatment. One patient who was recurred were repaired by laparoscope again, and no recurrence was found after this operation. This group of patients had occasional abdominal vascular injured, no bowel and important vascular injured in creating first trocar, and none had seroma or chronic pain.

Conclusion

It is safe and reliable to establish the first trocar and pneumoperitoneum with direct trocar in the laparoscopic incisional hernia repair. It is worthy to spread.

Key words: Incisional hernia, Direct trocar, Pneumoperitoneum, Laparoscopes
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