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中华腔镜外科杂志(电子版) ›› 2021, Vol. 14 ›› Issue (03) : 177 -180. doi: 10.3877/cma.j.issn.1674-6899.2021.03.010

病例报告

巨大腰疝经后腹腔镜全腹膜外补片修补术一例
刘星1, 李炳根2, 秦昌富3,()   
  1. 1. 236600 阜阳,安徽省太和县人民医院普通外科
    2. 511400 广州,南方医科大学附属何贤纪念医院普通外科
    3. 100043 北京,首都医科大学附属北京朝阳医院疝和腹壁外科
  • 收稿日期:2021-05-12 出版日期:2021-08-18
  • 通信作者: 秦昌富
  • 基金资助:
    北京市医院管理中心"青苗"计划专项经费资助(QML20170307)

Retroperitoneal totally endoscopic prosthetic repair of a huge lumbar hernia: a case report

Xing Liu1, Binggen Li2, Changfu Qin3,()   

  1. 1. Taihe Couty People′s Hopital, An Hui, Taihe, Fuyang 236600, China
    2. Department of General Surgery, Affiliated Hexian Memorial Hospital of Southern Medical University, Guangzhou 511400, China
    3. Department of Hernia and Abdominal Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
  • Received:2021-05-12 Published:2021-08-18
  • Corresponding author: Changfu Qin
引用本文:

刘星, 李炳根, 秦昌富. 巨大腰疝经后腹腔镜全腹膜外补片修补术一例[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(03): 177-180.

Xing Liu, Binggen Li, Changfu Qin. Retroperitoneal totally endoscopic prosthetic repair of a huge lumbar hernia: a case report[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(03): 177-180.

目的

总结1例巨大腰疝经后腹腔镜全腹膜外补片修补手术的诊治经验,探讨经后腹腔镜全腹膜外行腰疝补片修补手术的可行性。

方法

回顾1例巨大腰疝经后腹腔镜全腹膜外补片修补手术的治疗体会。

结果

成功为1例巨大腰疝患者行后腹腔镜全腹膜外补片修补术,手术顺利,术后随访1年余,患者恢复良好。

结论

腰疝总体发生率很少,只占所有腹外疝的1%~2%,本报道1例在车祸中因为安全带勒伤导致的巨大腰部膨出,通过经后腹腔镜全腹膜外补片修补技术为患者治愈,充分体现了层面解剖学在疝修补中的应用。

Objective

To summarize the diagnosis and treatment experience of a case of giant lumbar hernia through retroperitoneal laparoscopic total extraperitoneal patch repair, and to explore the feasibility of retroperitoneal totally endoscopic prosthetic repair of lumbar hernia.

Methods

Review the treatment experience of a case of giant lumbar hernia with retroperitoneal totally endoscopic prosthetic repair.

Results

We successfully performed the retroperitoneal totally endoscopic prosthetic repair for a patient with a giant lumbar hernia. The operation went smoothly. The postoperative follow-up was more than 1 year and the patient recovered well.

Conclusions

The overall incidence of lumbar hernia is very small, accounting for only 1%-2% of all external abdominal hernias. This article reports a case of a huge lumbar bulge caused by a seat belt strangulation in a car accident . We repaired it by retroperitoneal totally endoscopic prosthetic repair, R-TEP, which fully embodies the application of hierarchical anatomy in hernia repair.

图1 术前腹壁缺损情况
图2 术前腹部CT显示腹壁缺损情况,
图3 左侧卧位,腰部垫枕,完成术前标识
图4 术中布孔示意
图5 腹壁分区示意
图6 游离挛缩疝环进入腹膜与腹横筋膜之间的层面
图7 腹腔镜下倒刺线连续缝合以缩小腹壁缺损
图8 补片放置
图9 术后4个月腹部CT
图10 术后12个月腹部CT
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