腔镜定位后逆向穿刺法建立操作空间在完全腹膜外腹股沟疝修补术中的应用

doi:10.3877/cma.j.issn.1674-392X.2026.02.009

中华疝和腹壁外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 174 -177. doi: 10.3877/cma.j.issn.1674-392X.2026.02.009

论著

腔镜定位后逆向穿刺法建立操作空间在完全腹膜外腹股沟疝修补术中的应用

赵发宽^†(

), 梁伟纲, 杨义明, 祁木锐, 段应海

678400　云南芒市，德宏州人民医院普外二科

收稿日期:2023-07-27 出版日期:2026-04-18
通信作者: 赵发宽
基金资助:
德宏州人民医院科学研究基金项目(2022DY001)

Application of retrograde puncture following laparoscopic localization to create operative space in totally extra-peritoneal hernia repair

Fakuan Zhao^†(), Weigang Liang, Yiming Yang, Murui Qi, Yinghai Duan

The Second Department of General Surgery, People's Hospital of Dehong, Mangshi 678400, Yunnan Province, China

Received:2023-07-27 Published:2026-04-18
Corresponding author: Fakuan Zhao

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目的

探讨腹腔镜完全腹膜外疝修补术（TEP）中应用腔镜定位后逆向穿刺法建立操作空间的安全性及有效性。

方法

选择2020年4月至2022年9月德宏州人民医院收治的成人腹股沟疝行TEP术式患者81例。术中均采用腔镜定位后逆向穿刺法完成操作空间的建立。观察患者腹膜前间隙建立时间、术后并发症及复发情况。

结果

81例患者均顺利完成TEP手术，包括2例有下腹部手术史的患者，建立腹膜前间隙平均时间（7.5±2.2）min，无中转腹腔镜经腹腹膜前疝修补术，无穿刺导致的腹膜破裂、腹壁下血管损伤及术后出血情况发生。无患者疝复发。

结论

腔镜定位后逆向穿刺法建立操作空间安全、简便、有效，可推广应用。

关键词: 疝，腹股沟, 全腹膜外, 疝修补术, 腹腔镜

Objective

To discuss the safety and effectiveness of retrograde puncture following laparoscopic localization to create operative space in totally extra-peritoneal hernia repair (TEP).

Methods

A total of 81 adult patients with inguinal hernia who underwent TEP at People's Hospital of Dehong from April 2020 to September 2022 were selected. All patients underwent retrograde puncture following laparoscopic localization to create operative space. The time of creating the preperitoneal space, postoperative complications and recurrence of the patients were observed.

Results

All 81 cases completed TEP surgery, including two cases with low abdominal surgery history. The mean time for creating preperitoneal space was (7.5±2.2) min. There was no case of conversion to laparoscopic trans-abdominal preperitoneal hernia repair. No peritoneum tear and inferior epigastric vessels injury caused by puncture. There were no postoperative bleeding and no hernia recurrence.

Conclusion

Retrograde puncture following laparoscopic localization to create operative space for TEP repair is safe, simple and effective, and can be widely applied.

Key words: Hernia, inguinal, Totally extra-peritoneal, Herniorrhaphy, Laparoscopes

图9 两手器械配合分离腹膜前间隙

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Application of retrograde puncture following laparoscopic localization to create operative space in totally extra-peritoneal hernia repair

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Application of retrograde puncture following laparoscopic localization to create operative space in totally extra-peritoneal hernia repair