总结单针三明治固定技术在腹股沟直疝前入路腹膜外修补术中的操作技巧与临床应用经验。

回顾性分析2012年3月至2014年3月泰安市第一人民医院同一手术组完成的68例直疝患者临床资料，其中102侧疝，双侧疝34例，右侧疝23例，左侧疝11例；复合疝3例，2例为斜疝Lichtenstein术后再发直疝，4例为直疝Lichtenstein术后复发。分析手术技巧、术中和术后并发症、5年以上的随访资料。

手术均成功，手术时间（22.35±14.26）min，术中无明显出血，1例腹壁下静脉主干牵拉损伤术中结扎，术中均未放置引流，术后无血清肿。术后近期无剧烈疼痛，远期无顽固性疼痛。随访期间无直疝复发病例，1例术后2年另发斜疝，再次手术治愈,1例高龄患者因其他疾病术后2年死亡。

单针三明治缝合固定技术在直疝前入路腹膜外修补术中具有操作简单、效果确切的优点，直疝分离腹膜外间隙要避免遗留隐匿斜疝。

To summarize the operation technique and clinical application of single needle sandwich fixation technique in anterior extraperitoneal repair of direct inguinal hernia.

Clinical data of 68 patients with direct hernia performed by the same surgery group between March 2012 and March 2014 in Tai'an City first people's hospital were retrospective reviewed. In this study, 68 patients had 102 hernias, 34 bilateral hernias, 23 right hernias and 11 left hernias, including 3 cases of composite hernia, 2 cases of indirect hernia after Lichtenstein's surgery for indirect hernia and 4 cases of recurrent direct hernia after Lichtenstein's surgery. The operative skills, intraoperative and postoperative complications and the follow-up data of more than 5 years were analyzed.

All operations were successful, the operation time was (22.35±14.26) minutes, and there was no significant bleeding during the operation. 1 case of inferior epigastric vein main traction injury was ligated during the operation. No drainage was placed during the operation, and there was no seroma after the operation. There was no severe pain in the short term and no refractory pain in the long term after the operation. During the follow-up period, there was no recurrence of direct hernia, 1 case had another indirect hernia two years after surgery, which was cured by reoperation, and 1 elderly patient died two years after surgery due to other diseases.

Single-needle sandwich suture fixation technique has the advantages of simple operation and accurate effect in the extraperitoneal repair of anterior approach for direct hernia. Occult indirect hernia should be avoided in direct hernia extraperitoneal space separation.