Abstract: Objective To explore the management for peritoneal tears during laparoscopic extraperitoneal inguinal hernia repair （TEP）. Methods A retrospective analysis was performed in 141 cases with TEP surgery from January 2015 to January 2020, to analyze the causes of peritoneal rupture during TEP surgery, the size and location, and the management. The operation time, transfer procedure, surgical complications, and hospital stay were compared between patients with and without peritoneal tears during inguinal hernia repair in the same period. Results Among the 141 cases of TEP surgery in this group, 58 cases had intact peritoneum without rupture, 83 cases had peritoneal tears, and 2 cases were transferred to TAPP. The operation time of patients in the peritoneal rupture group was 42.34±13.52 min, and the operation time of patients in the peritoneal tears group was 57.13±18.38 （P<0.01）. Postoperative seroma, postoperative umbilical incision redness and swelling, local pain, hospitalization days, surgical complications were no significant statistical differences follow-up 6 to 24 months. The patient has no special discomfort, and resumed normal work and life. Conclusion The peritoneal tears during TEP operation will collapsing preperitoneal space and prolong the anesthesia and operation time. In addition to the patient′s own condition, it is also related to the operator′s operating experience, but does not increase surgical and hospital stay.

Key words: peritoneal tears, extraperitoneal inguinal hernia repair （TEP）, complications

摘要： 目的 探讨腹腔镜下腹膜外腹股沟疝修补术（TEP）手术中腹膜破裂后处理对策。方法 回顾分析2015年1月~2020年1月在我院腹股沟疝行TEP手术的所有病例,总结TEP手术中腹膜破裂的原因、裂口的大小、位置及处理对策。比较同期病例腹股沟疝修补术中腹膜破裂和完整的患者手术时间、中转术式、手术并发症、住院时间的差异。结果 本组141例TEP手术中,腹膜完整无破裂58例,腹膜破裂83例,初期有2例中转TAPP。腹膜无破裂组患者的手术时间42.34±13.52 min,腹膜破裂组患者的手术时间57.13±18.38,两组对比P<0.01。术后血清肿,术后脐部切口红肿,局部疼痛,住院天数、手术并发症无明显差异,随访6~24月无复发,患者无特殊不适,恢复正常工作生活。结论 TEP手术中腹膜破裂会影响手术操作空间,延长麻醉和手术时间,除了患者本身情况外,还与术者的操作经验有关,但不增加手术并发症和住院时间。

关键词: 腹腔镜, 腹股沟斜疝, 腹膜破裂, 并发症