探讨腹腔镜免输精管分离腹股沟疝平片修补法的安全性与可行性。

回顾性分析2014年12月至2017年1月苏州大学附属第一医院普外科收治的352例男性腹股沟疝患者（其中单侧直疝75例，单侧斜疝162例，双侧斜疝67例，双侧直疝27例，单侧斜疝+直疝18例，单侧股疝3例），所有患者均行腹腔镜免输精管分离腹股沟疝平片修补。统计手术时间及术中出血量、术后观察局部血肿、血清肿、疼痛、住院时间、复发及射精等指标。

352例患者均在腹腔镜下完成修补手术，共修补446例次，单侧发病手术时间为（105.2±12.6）min，双侧发病手术时间为（155.7±23.4）min，所有术中关闭腹膜切口时间为（12.5±2.3）min。术中出血量（2.3±0.57）ml，术后局部腹股沟区酸胀34例（9.66%），疝囊积液26例（7.39%），阴囊皮下气肿12例（3.41%），余无其他并发症发生。术后住院（3.23±1.23）d，近期随访无复发，亦未出现射精异常病例。

腹腔镜免输精管分离腹股沟疝修补法免除了输精管及疝囊的分离，简化了腹膜前间隙的分离操作，是安全可行的手术方式。更重要的是有效避免了术中、术后对输精管的损伤和侵扰。

To explore the safety and feasibility of laparoscopic exempt spermaduct inguinal hernia repair.

From December 2014 to January 2017, 352 male patients with an inguinal hernia were extracted randomly to the first affiliated hospital of soochow university, including 75 unilateral direct hernia cases, 162 unilateral indirect hernia cases, 67 bilateral indirect hernia cases, 27 bilateral indirect hernia case, 18 unilateral direct and indirect hernia cases and 3 unilateral femoral hernia case. All patients underwent laparoscopic exempt spermaduct inguinal hernia repair. The indicators of operation time, blood loss of intraoperation, postoperative local trauma, pain, hospital stay, recurrence, and ejaculation were collected and analysed.

All 352 patients were repaired under laparoscopy, and a total of 446 repairs were performed. The unilateral operation times were (105.2±12.6) minutes. The bilateral operation time was (155.7±23.4) minutes. The time of peritoneal incision closure was (12.5±2.3) minutes. Intraoperative blood loss was (2.3±0.57) ml. There were 34 cases (9.66%) who had comfronted discomfort in the local inguinal region, and there were 26 cases (7.39%) who had met with hernial sac effusion. 12 patients (3.41%) had the symptom of subcutaneous emphysema of the scrotum. No complications occurred in the remaining patients. The hospital stays of postoperation were (3.23±1.23) days, and there were no recurrences of recent follow-up and no malemissions.

The laparoscopic exempt spermaduct inguinal hernia repair had exempted the separation of spermaduct and hernial sac and simplified the segregation of preperitoneal space. The laparoscopic exempt spermaduct inguinal hernia repair is a safe and feasible operation. More importantly, it effectively avoided the damage and disturbance of the spermaduct.