探讨腹腔镜经腹腹膜前疝修补术（TAPP）治疗嵌顿性股疝的临床疗效和技术难点。

回顾扬州大学附属苏北人民医院2018年1月至2021年10月经TAPP治疗嵌顿性股疝患者24例的临床资料，统计分析患者的术中发现及处理方法，手术相关指标（手术时间、术中出血量、住院时间），术后并发症（切口感染、浆液肿、补片感染等）及复发率。

24例患者均完成TAPP治疗，完全腹腔镜下回纳疝内容物22例，有2例因初始经验不足，术中辅助小切口回纳嵌顿的疝内容物。11例患者发生小肠嵌顿，其中4例手法复位失败，术中电钩切开髂耻束回纳小肠，术中探查复位的嵌顿肠管无损伤或坏死。4例患者探查发现隐匿疝，3例行TAPP双侧股疝手术，另1例因患者90岁高龄，为减少麻醉时间及手术创伤，未同时行隐匿疝修补术。手术时间45~150 min，平均（84.87±26.10）min；术中出血量5~30 ml，平均（9.58±6.06）ml；住院时间2~15 d，平均（6.70±3.07）d。术后出现浆液肿1例，予穿刺抽液后好转；术后排尿困难1例，予留置导尿管2 d后好转。术后无切口感染。通过电话或患者来院复诊随访，随访时间3个月~2年，未发现补片感染和疝复发。

嵌顿性股疝患者行TAPP治疗安全、有效，可减少二次手术率，术后并发症少。

To explore the clinical efficacy and technical challenges of laparoscopic transabdominal preperitoneal hernioplasty (TAPP) in treating incarcerated femoral hernias.

A retrospective analysis was conducted on 24 patients with incarcerated femoral hernia treated with TAPP at the Northern Jiangsu People's Hospital Affiliated to Yangzhou University from January 2018 to October 2021. Clinical data that intraoperative findings and management methods, surgical-related indicators (operative time, intraoperative blood loss, length of hospital stay), postoperative complications (wound infection, seroma formation, mesh infection), and recurrence rate, were analyzed.

All 24 patients successfully underwent TAPP treatment. Of these, 22 patients had their hernia contents completely reduced laparoscopically, while 2 required an auxiliary small incision to reduce the incarcerated hernia contents due to initial inexperience. In 11 patients, there was an intestinal incarceration; out of which, 4 cases failed in manual reduction. During the procedure, the iliopubic tract was incised using an electrosurgical hook to reduce the small intestine. Subsequent examination revealed that the reduced incarcerated intestine had no damage or necrosis. During the exploratory procedure of 4 patients, a concealed hernia was discovered. Three of these patients underwent TAPP surgery for bilateral femoral hernias. One patient, aged 90, did not undergo simultaneous repair of the concealed hernia to reduce anesthesia time and surgical trauma. The surgery lasted between 45 to 150 minutes, averaging 84.87±26.10 minutes. Intraoperative blood loss ranged from 5 to 30 ml, with an average of 9.58±6.06 ml. The hospital stay varied between 2 to 15 days, averaging 6.70±3.07 days. One patient developed postoperative seroma, which improved after aspiration. Another patient faced difficulties in urination postoperatively and showed improvement after a urinary catheter was retained for 2 days. There were no cases of wound infection. Through phone follow-ups or patient revisits, during a period ranging from 3 months to 2 years, no mesh infections or hernia recurrences were identified.

The TAPP treatment method for patients with incarcerated femoral hernia is safe and effective. This method can not only reduce the need for a second surgery, but also has fewer postoperative complications.