LAPAROSKOPİK İNGUİNAL HERNİ ONARIM TEKNİĞİ VE KLİNİK SONUÇLARIMIZ

Yıl 2004, Cilt: 10 Sayı: 1, 21 - 25, 01.03.2004

Özgür Özdamar Eşref Oğuz Özgür Erdal Onur Ali Çay Ali Galip Deneçli

Öz

Laparoskopik inguinal herni onarımı ilk kez 1982 yılında Ger tarafından uygulanmıştır. 1990’da Popp tıkaç ve yama tekniğini, Fitzgibbons da IPOM Intraperitoneal Onlay Mesh tekniğini tarif etmiştir. Bugün için en popüler teknikler ise TAPP Transabdominal preperitoneal onarım ve TEP Total ekstraperitoneal onarım teknikleridir. Bu çalışmada Nisan 2002 / Temmuz 2003 tarihleri arasında laparoskopik inguinal herni onarımı yaptığımız 26 hastanın klinik sonuçlarını değerlendirdik. Tekniği elektif hasta grubuna uyguladık. Acil ve nüks olgulara bu tekniği uygulamadık. 24 olguya total ekstraperitoneal TEP , 2 olguya ise transabdominal preperitoneal onarımı TAPP uyguladık. Mortalite veya major peroperatif komplikasyon gözlemedik. 1 olguda %4 erken dönemde yetersiz fıtık kesesi diseksiyonuna bağlı olarak nüks gözledik

Anahtar Kelimeler

İnguinal herni, laparoskopi, preperitoneal onarım, transabdominal yaklaşım

LAPAROSCOPİC INGUİNAL HERNİA REPAİR TECHNİQUE AND OUR CLİNİCAL RESULTS

Öz

Laparoscopic inguinal hernia repair has been first performed by Ger in 1982. In 1990 Popp has described plug and patch technique, and Fitzgibbons has described IPOM Intraperitoneal Onlay Mesh technique. But the most popular techniques for today are TAPP Transabdominal preperitoneal repair and TEP Total extraperitoneal repair . In thıs study, we evaluated clinical results of 26 patients that we performed laparoscopic inguinal hernia repair between April 2002 and July 2003. We performed this technique to a group of elective patients. We did not perform this technique to urgent or recurrent patients. We performed totally extraperitoneal repair TEP to 24 patients and transabdominal preperitoneal repair TAPP to 2 patients. We did not observe any mortality or major peroperative complication. We observed recurrence at 1 patient %4 in early period because of inadequate hernia sac dissection

Anahtar Kelimeler

Inguinal hernia, laparoscopy, preperitoneal repair, transabdominal approach

Kaynakça

• Read RC. The development of inguinal herniorraphy. Surg Clin of North America 1984; 64 (2): 185-97
• Read RC. The development of inguinal herniorraphy in the 20th century. Surg Clinics of North America, 395-411, 1993
• Swanstrom L., Laparoscopic herniorraphy. Surg Clin of North Am 1996; 76: 483-91
• Ger R. The management of certain abdominal hernias by intraabdominal closure of the neck. Ann R Coll Surg Engl 1982; 64: 4
• Fitzgibbons RJ: Laparoscopic inguinal herniorraphy. Results of a multicenter trial; Ann Surg 221: 3-13, 1995
• Corbit JD JR. Transabdominal peritoneal herniorraphy. Surg Laparosc Endosc 1993; 3: 328-32
• McKernan, Laws H. Laparocopic preperitoneal prosthetic repair of hernias. Surg Round, 15: 597-608,1992
• Nyhus LM , Iliopubic tract repair of inguinal and femoral hernia. The posterior approach, Surgical Clinics of North America, June Rutkow IR. Epidemiologic, economic and sociologic aspects of hernia surgery in the United States in the 1990s. Surg Clin North Am 1998; 78: 941-51
• Kulaçoğlu HI, Ozmen MM, Oruç MT: Laparoscopic herniorraphy. Preference rate among surgeons in Ankara, Turkey. East Afr Med J 2001 Apr; 78(4): 216-9
• McFadyen BV, Charles RM. Inguinal herniorraphy; complications and recurrences: Seminars in Laparoendoscopic Surgery ipph; 240 Vanclooster P, Smet B. Laparoscopic inguinal hernia repair: Review of 6 years experience; Acta Chir Belg 2001, 101 (3):135-8
• G.S. Ferzli, T. Kiel et al. Pneumothorax as a complication of laparoscopic inguinal hernia repair: Surgical Endoscopy 1997 11: 153
• Dalessandri KM, Bhoyrul S, Mulvihill SJ. Laparoscopic hernia repair and bladder injury: JSLS 2001; 5(2): 175-7
• Mincheff T, Bannister B, Zubel P. Focal testicular infarction from laparoscopic inguinal hernia repair. JSLS 2002; 6(3): 211-3.
• Diana V. Vogt et al. Preliminary results of a prospective randomized trial of laparoscopic onlay versus conventional inguinal herniorraphy: The American Journal of Surgery 1995; 169: 84-90
• Kozol R et al. A prospective randomized study of open vs laparoscopic inguinal hernia repair: An assesment of postoperative pain . Archives of Surgery 1997; 132: 292-295
• Vatansev C, Belviranlı M et al. The effects of different hernia repair methods on postoperative pain medication and CRP levels: Surg Laparoscopic Endoscopy and Percutan Tech 2002; 12(4): 243-6
• Hill ADK. Inflammatory markers following laparoscopic and open hernia repair: Surgical Endoscopy 1995; 9: 695-698
• Fazzio FJ Jr. Cost – effective, reliable laparoscopic hernia repair: a report on 500 consecutive repairs: Surg Endosc 2002; (6):931-5
• Greenberg D, Peiser JG: Costs and benefits of laparosopic inguinal hernia repair- is there an economic justification?; Harefuah ;140(7):580-5,680