Minimally invasive procedure operation for indirect inguinal hernia

There are six Minimally invasive procedure methods for indirect inguinal hernia:

The inner ring closure: It is equivalent to the high -level ligation of the hernia sac during open surgery. Because it does not repair the back wall of the groin, it is only applicable to the oblique hernia of the children's groin.

Plug and Patch: Purchase the implant directly into the defect. Because the implant is easy to shift and the restrictions are repaired, the recurrence rate and reconstruction rate are high. At present, it is rarely applied. It is recommended not to use this method for inguinal hernia repair.

Intra PeritoneAl onlay Mesh (IPOM) in the abdominal cavity. IPOM is the main method for treating incision hernias. When repairing the inguinal hernia, it is easy to improve because the supplementary tablets are easy to shift: such as the central fixation of the supplement, sutures around the fillet, open the peritoneum to fix the supplement with the pubic nodules or the COOPER's ligament. In order to prevent abdominal adhesion, polyphyle and polytefluorophysiconic composite materials (such as Composix Mesh) or puffed polyetrafluoro Bylflin (such as Dual Mesh) are more expensive.

IPOM+Internal Ring Pooplasty: Add the internal ring forming technique on the basis of the IPOM, and the abdominal horizontal fascia and the illegitimate shame are about to reduce the inner ring, which is equivalent to open March. This method is difficult to operate, and there are very few applications at present.

TranSabdominal Preperitoneal (TAPP): Open the peritoneum in the abdominal cavity, dissect an anterior gap in the pair, and combine the supplement with the COOPER's ligament, pubic nodule, abdominal rectus and combined tendon taper. Close the peritoneum. Principles are equivalent to the open anterior peritoneal supplementation of RIVES and Stoppa in the 1980s.

Totally Extraperitoneal (TEP): directly entering the anterior gap in the peritoneal without entering the abdomen, which is equivalent to an open Kugel surgery. The nailing method is the same as TAPP. TAPP and TEP are fixed with the firm structural tissue with a firm structure. At the same time, the oblique hernia inner mouth, straight hernia triangle and stock ring mouth are reasonable. Surgical method of groin hernia repair. Today's two laparoscopic groin hernia minimally invasive treatment methods are not obviously different from the quality, depending on the degree of mastery of surgeons. We currently use the TAPP method to receive good treatment effects. Fast, painful.

Anesthesia and position

It is recommended that the tracheal intubation and whole body anesthesia.

The head is 10 ~ 15 degrees flat. The surgeon is operated on the opposite side of the affected side, and the assistant is located on the affected side or the head of the head. The monitor is placed below the operating table.