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Minilaparoscopy For Inguinal Hernia Repair

机译:腹腔镜疝修补术

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Background and Objectives: Inguinal hernia repair is among the most common procedures performed worldwide and the laparoscopic totally extraperitoneal (TEP) approach is a recognized and effective surgical technique. Although technically advantageous because of the option of no mesh fixation and no need for creation of a peritoneal flap resulting, in less postoperative pain and faster recovery, TEP has not achieved the popularity it deserves, mainly because of its complexity and steep learning curve. Minilaparoscopy was first described in the 1990s and has recently gained significantly from better instrumentation that may increase TEP's effectiveness and acceptance. We performed a prospective study, to analyze the outcomes of minilaparoscopy in pain and operative time when compared to the conventional laparoscopic technique in hernia repair. Methods: Fifty-eight laparoscopic inguinal hernia repairs were performed: 36 by traditional laparoscopic technique and 22 by minilaparoscopic instruments (mini). A study protocol was applied prospectively for data collection. Variables analyzed were early postoperative pain (at hour 6 after procedure), pain at discharge, use of on-demand analgesics, and operative time. Results: The mini group presented reduced early postoperative pain and operative time. The present study also suggests less postoperative pain at discharge with mini procedures, although this difference was not statistically significant. No difference between the groups regarding on-demand use of analgesics was found. Conclusions: This study corroborates findings in previously published papers that have shown the feasibility of minilaparoscopy in laparoscopic TEP hernia repair and its benefits regarding postoperative pain, operative time, and aesthetic outcomes.
机译:背景与目的:腹股沟疝修补术是全世界最常见的手术之一,腹腔镜完全腹膜外(TEP)手术是公认的有效手术技术。尽管在技术上由于没有网眼固定的选择以及不需要产生腹膜瓣的优点而在技术上具有优势,从而减轻了术后疼痛并加快了康复速度,但TEP仍未达到应有的受欢迎程度,主要是因为其复杂性和陡峭的学习曲线。微型腹腔镜在1990年代首次被描述,最近通过更好的仪器获得了显着的进步,可以提高TEP的有效性和接受度。我们进行了一项前瞻性研究,以分析与常规腹腔镜技术在疝修补术中相比,微型腹腔镜手术在疼痛和手术时间方面的结果。方法:58例腹腔镜腹股沟疝修补术:36例采用传统腹腔镜技术,22例采用微型腹腔镜器械。前瞻性地将研究方案应用于数据收集。分析的变量为术后早期疼痛(术后6小时),出院时疼痛,按需使用镇痛药和手术时间。结果:迷你组表现出减轻了术后早期疼痛和手术时间。本研究还表明,采用小型手术可以减轻出院时的术后疼痛,尽管这种差异在统计学上并不显着。两组之间在按需使用镇痛药方面没有差异。结论:这项研究证实了以前发表的论文中的发现,这些论文显示了微型腹腔镜在腹腔镜TEP疝修补术中的可行性及其在术后疼痛,手术时间和美学效果方面的益处。

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