介绍一种腹腔镜下腹壁切口疝修补术中补片悬吊固定的简易和有效的方法。

回顾性分析2017年1月至2018年8月，浙江省人民医院采用"栓套"引线的方法固定补片的17例腹腔镜切口疝修补术病例的临床资料，统计悬吊固定时间、悬吊针数、皮肤渗血针孔数、"栓套"线更换次数、术后疼痛情况及术后住院时间，评价该方法的操作可行性及临床治疗效果。

17例患者均顺利完成腹腔镜下操作，补片悬吊固定时间45～82 min，平均61.3 min；悬吊针数14～28针；皮肤渗血针孔数0～3个；"栓套"线更换0～2根；术后疼痛评分1～4分；术后住院时间2～6 d。术后未出现补片感染、移位、肠瘘、腹腔室间隔综合征等严重并发症，随访1～20个月，平均13个月，未出现切口疝复发。

"栓套"引线法在腹腔镜切口疝修补术中十分简单，学习曲线短，操作时间稳定，不依赖于腔镜下特殊引线器具，不需用钉枪，经济适用，术后补片固定引起的相关并发症少。

To introduce a simple and effective method of mesh suspension fixation in laparoscopic incisional hernia repair.

From January 2017 to August 2018, 17 cases of laparoscopic incisional herniorrhaphy with patch fixed by "a special noose" to catch suture were retrospectively analyzed. The time of suspension fixation, the number of suspension needles, the number of pinholes in bleeding, the number of changes of suture in "noose" , postoperative pain and hospitalization time were counted. The feasibility and clinical effect of the method were evaluated.

All the 17 patients successfully completed laparoscopic operation. Patch suspension fixation time was 45 to 82 minutes, with an average of 61.3 minutes; suspension needles number was 14 to 28; the number of bleeding was 0 to 3 pinholes; "noose" suture changes number was 0 to 2; postoperative pain score was 1 to 4 points; postoperative hospital stay was 2 to 6 days. No serious complications such as patch infection, displacement, intestinal fistula, abdominal compartment syndrome occurred after operation. Follow-up period ranged from 1 to 20 months, with an average of 13 months. No recurrence of incisional hernia occurred.

The method of using "a special noose" to catch suture is very simple and easy in laparoscopic incisional hernia repair, with short learning curve and stable operation time. It does not depend on special laparoscopic apparatus or tacks to achieve the suture. It is thought to be an economic application. Also, there are few postoperative complications caused by patch fixation.