Clinical Analysis Of 12 Cases Of Inguinal Incarcerated Hernia Treated By Transabdominal Preperitioneal Laparoscopic Inguinal Herniorrhaphy

Objective: To investigate the feasibility,indications,advantages,mesh selection and postoperative effects of transabdominal preperitioneal laparoscopic inguinal herniorrhaphy(TAPP)on the treatment of inguinal incarcerated hernia.Methods: The clinical data of 12 cases of patients with inguinal incarcerated hernia treated by TAPP at our hospital from January 2015 to December 2015 were studied.The operative time,hospital stay,complications,recurrence and other factors were analyzed.Results: The surgeries of all the patients were successful without needs to conduct small intestine resection and conversion to laparotomy,and were all cured while left the hospital.The shortest operation time was 80 min and the longest was 190 min with a mean operation time of 130 min.The postoperative hospital stay was 6-12 days with a mean hospital stay of 8 days.The incarcerated hernia contents were small intestines in 7 cases,omentum in 4 cases,small intestine combined with omentum in 1 case.Postoperative seroma in inguinal region was appeared in 1 case and scrotal seroma in 1 case,and no chronic pain,scrotal hematoma,bowel obstruction,wound infection,patch infection and other complications were found.The follow-up was 1-12 months with no recurrent patients or follow-up lost cases.Conclusion: 1.The treatment of TAPP in curing the inguinal incarcerated hernia was feasible and safe.2.Compared with traditional open surgery,TAPP can better observe and judge the vitality of the incarcerated hernia contents,easily find the automatically returned hernia contents after anesthesia,and also avoid the necrotic bowel tubes within the abdominal cavity with the missing retrograde incarcerated hernia.3.TAPP surgery can release the hernia ring under a direct vision and bring the hernia contents back.The mesh repair was conducted in the preperitoneal space,avoided the heavy edema bleeding sites,and reduced the chance of infection patch.4.Since there were a relative small amount of patients in the group,the superiority of TAPP in the treatment of the inguinal incarcerated hernia needed more big data and evidence-based medicine to support.