关键词: 腹腔镜, 腹股沟嵌顿疝, 疝环充填式无张力疝修补术

Abstract: 【Abstract】 Objective To investigate the feasibility and clinical value of laparoscopic reduction and plug?mesh tension?free hernia repair in treatment of adult incarcerated inguinal hernia. Methods The clinical data of 46 patients with adult incarcerated inguinal hernia, who underwent laparoscopic reduction and plug?mesh tension?free hernia repair between June 2012 and June 2016，were analyzed retrospectively. Results Spontaneous reduction was occurred during the procedure of general anaesthesia in 11 patients and incarcerated small bowels were detected during laparoscopic examination. Strangulated small bowels were found in one patient who underwent enterectomy. The incarcerated tissues were reduced laparoscopically in the other 35 patients and strangulated omentum was found in two patients. The blood white cell count of peritoneal effusion ranged from 1.32×109/L to 78.81×109/L，（mean，25.34±11.03 ×109/L），while the count of extrasac effusion were from 0.18×109/L to 2.31×109/L，（mean，0.42±0.28 ×109/L）. The pus cells were not found in effusion of hernia sac. An incident finding of contralateral occult indirect hernia was also noted during laparoscopic exploration in 5 cases who underwent ligation of hernia ring，and fatty liver in seven cases，hepatic cyst in 14 cases，diverticulum of jejunum in one case，respectively. All patients underwent plug ? mesh tension ? free hernia repair successfully. The operation time ranged from 75 minutes to 110 minutes with a mean of 87.4 minutes. The hospital stay was 5 to 7 days with a mean of 6.7 days. The function of the bowel recovered in 15~36 hours with a mean of 20.4 hours. The postoperative seroma was found in 5 patients，transient paresthesia in 3 patients，and fat liquefaction of incisions in 1 patient who was cured by strengthening the wound disinfection. There were no complications in other patients. The follow?up periods arranged from 4 months to 36 months（mean， 22.8 months）. All of the patients had no recurrent hernias. Conclusion The procedure of laparoscopic reduction and plug?mesh tension?free hernia repair in treatment of adult incarcerated inguinal hernia has the advantage of complete exploration，timely reduction，spontaneous repair，safety and feasibility.

Key words: plug?mesh tension?free hernia repair, laparoscopy, incarcerated inguinal hernia