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The quality control of inguinal hernia is a key point of herniology development in China, which is on the basis of continuous clinical quality improvement. The standardized operation of inguinal hernia repair requires the tacit cooperation of surgeons and the operating room nursing team. According to the existing mature seven step method in inguinal hernia surgery, the authors summarize the seven step nursing process of operation, in order to provide smoother and better operation guarantee in open and laparoscopic hernioplasty.
ABSTRACT
ABSTRACT Background: Laparoscopic inguinal hernia repair has been shown to be superior than open repairs with faster return to daily activities and decrease in the occurrence of chronic pain. However, higher direct costs and mandatory use of general anesthesia are arguments against their use. In addition, increased complexity of surgery resulting from an anatomy that is unusual to general surgeons prevents the widespread adoption of laparoscopic approach. Aim: To propose a technical systematization for transabdominal laparoscopic repair (TAPP) of inguinal hernias based on anatomical concepts. Method: To offer a systematization of TAPP repair based on well defined anatomic landmarks, describing the concept of "inverted Y", identification of five triangles and three zones of dissection, to achieve the "critical view of safety" for laparoscopic inguinal hernia repair. Results: Since this standardization was developed five years ago, many surgeons were trained following these precepts. Reproducibility is high, as far as, it´s rate of adoption among surgeons. Conclusion: The concept of the "inverted Y", "Five triangles" and the dissection based in "Three Zones" establish an effective and reproducible standardization of the TAPP technique.
RESUMO Racional: O reparo laparoscópico da hérnia inguinal tem se mostrado superior aos reparos abertos, com retorno mais rápido às atividades diárias e diminuição na ocorrência de dor crônica. No entanto, custos diretos mais altos e o uso obrigatório de anestesia geral são argumentos contra seu uso. Além disso, o aumento da complexidade da operação resultante de uma anatomia incomum aos cirurgiões gerais impede a ampla adoção da abordagem laparoscópica. Objetivo: Propor uma sistematização técnica para reparo laparoscópico transabdominal (TAPP) de hérnias inguinais com base em conceitos anatômicos. Método: Oferecer sistematização do reparo do TAPP baseado em pontos anatômicos bem definidos, descrevendo o conceito de "Y invertido", identificação de cinco triângulos e três zonas de dissecação, para alcançar a "visão crítica de segurança" para o reparo de hérnia inguinal laparoscópica. Resultados: Desde que essa padronização foi desenvolvida há cinco anos, muitos cirurgiões foram treinados seguindo esses preceitos. A reprodutibilidade é muito alta, assim como a taxa de adoção entre cirurgiões. Conclusão: O conceito de "Y invertido", dos "Cinco triângulos" e a dissecção baseada em "Três Zonas" estabelecem uma padronização efetiva e reprodutível da técnica TAPP.
Subject(s)
Humans , Male , Laparoscopy/methods , Herniorrhaphy/methods , Hernia, Inguinal/surgery , Reproducibility of Results , Treatment OutcomeABSTRACT
ObjectiveTo evaluate results of the Lichtenstein tension-free mesh repair and summaraize the clinical experience in the treatment of the inguinal hernia. MethodsIn this retrospective study, 4011 tension-free inguinal hernia repairs were performed in 3631 patients, using a polypropylene mesh (Lichtenstein technique). Results The average hospitalization was 3.8 days, the overall complication rate was 2.4％, the recurrence rate was 0.1％. ConclusionThe Lichtenstein repair for the treatment of inguinal hernia has the advantage of less postoperative pain and low recurrence and is highly suitable for day case surgery.
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Objective To estimate the clinical value of curing children Oblique inguinal hernia through scrotum's small professional jargon.Methods 101 children with Oblique inguinal hernia through scrotum's small incision were regaled as the observation group.They were in our hospital from March 2006 to October 2008.98 patients of children Oblique inguinal hernia through small transverse incision on the surface projection of the perficial inguinal ring were regarded as the control group.They Were in our hospital from August 2003 to February 2006.The operation time,the blood loss in operation,the postoperative serotal hematoma,the wound healing,the postoperative recidivation were analyzed and compared.Results The operation time,the wound healing and the postoperative reeidivation were not obviously different between the two groups.The blood loss in operation and the postoperative scrotal hematoma were obviously different between the two groups(P＜0.05);The later average time was shorter than that of the control group through observing the operation time in different stage of the observation group.There was no obviously incision trace in the observation group.Conclusion The method of curing children Oblique inguinal hernia through scrotum's small professional jargon was more direct and easier to operate when finding sac of hemia furthermore,neision concealment.so it has clinical value.