BALLOON DISSECTION FACILITATED LAPAROSCOPIC EXTRAPERITONEAL HERNIOPLASTY

被引:43
作者
KIETURAKIS, MJ
NGUYEN, DT
VARGAS, H
FOGARTY, TJ
KLEIN, SR
机构
[1] UNIV CALIF LOS ANGELES,HARBOR MED CTR,DEPT SURG,TORRANCE,CA 90509
[2] STANFORD UNIV,DEPT SURG,PALO ALTO,CA 94304
[3] SEQUOIA HOSP,REDWOOD CITY,CA
关键词
D O I
10.1016/S0002-9610(05)80130-8
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: With the goals of minimizing perioperative morbidity and obtaining direct inguinal access without transgressing the peritoneal cavity, we developed a balloon dissection device to facilitate laparoscopic extraperitoneal hernioplasty. PATIENTS AND METHODS: me have performed balloon facilitated dissection on 113 patients (105 males) on an outpatient basis, Some patients were repaired under regional anesthesia. A total of 150 hernias have been repaired: 72 indirect, 10 direct, 3 scrotal, 2 sliding, 2 spigelian, and 1 femoral. RESULTS: Mean operating time was 60 minutes. All patients were ambulatory on discharge. Half reported minimal or no immediate postoperative pain. Over 80% had only minimal irritation or discomfort on the third postoperative day. Nearly 60% returned to work within 2 weeks. None required hospital readmission for an immediate complication of hernioplasty. With a mean follow-up of 6.3 months, only three recurrences are reported. Except for one persistent neuropathy which resolved after staple removal, there were no significant complications. CONCLUSIONS: We conclude that balloon dissection facilitates laparoscopic extraperitoneal hernioplasty and obviates the need for general anesthesia. Our approach minimizes perioperative pain. It can be done on an outpatient basis and permits prompt return to full activity including physical work.
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页码:603 / 608
页数:6
相关论文
共 24 条
[1]  
ATABEK U, 1994, AM SURGEON, V60, P255
[2]  
BROOKS DC, 1994, ARCH SURG-CHICAGO, V129, P361
[3]  
Felix E L, 1993, J Laparoendosc Surg, V3, P1, DOI 10.1089/lps.1993.3.1
[4]  
Ferzli G S, 1992, J Laparoendosc Surg, V2, P281, DOI 10.1089/lps.1992.2.281
[5]  
FILIPI CJ, 1992, SURG CLIN N AM, V72, P1109
[6]  
GEIS WP, 1993, SURGERY, V114, P765
[7]   MANAGEMENT OF INDIRECT INGUINAL-HERNIAS BY LAPAROSCOPIC CLOSURE OF THE NECK OF THE SAC [J].
GER, R ;
MONROE, K ;
DUVIVIER, R ;
MISHRICK, A .
AMERICAN JOURNAL OF SURGERY, 1990, 159 (04) :370-373
[8]   MANAGEMENT OF GROIN HERNIAS BY LAPAROSCOPY [J].
GER, R ;
MISHRICK, A ;
HURWITZ, J ;
ROMERO, C ;
ODDSEN, R .
WORLD JOURNAL OF SURGERY, 1993, 17 (01) :46-50
[9]  
GER R, 1982, ANN ROY COLL SURG, V64, P342
[10]  
HOFFMAN HC, 1993, ARCH SURG-CHICAGO, V128, P964