The Comparison Of Free Vas Deferens For Repair Of Inguinal Hernia And Transabdominal Preperitoneal Prothesis

Objective: In order to observe the clinical effect and application value of laparoscopic free vas deferens(LFVD)transabdominal preperitoneal(LFVD-TAPP)repair of inguinal hernia in the design of this article,it is compared with the current mainstream transabdominal preperitoneal prothesis(TAPP)operation.Methods: Clinical data of 285 Inguinal hernia patients in the Department of General Surgery of the First Affiliated Hospital of Soochow University from December 2014 to August 2016 was analyzed.According to the different Surgical approach,we divide data into the treatment group which has 148 cases and the control group which has 137 cases.The treatment group underwent free vas deferens(LFVD)transabdominal preperitoneal repair of inguinal hernia,Key points of operation approach: perform puncture of the gap in front of the peritoneum under the laparoscopic monitoring,as well as expansion and separation of the gap in front of the peritoneum in the myopectineal orifice without separation of the surface peritoneum of vas deferens or uterine round ligament.For oblique hernia patients,the surface peritoneum was annularly incised along the inner ring of the outer circumference without free hernia sac.Conventional TAPP approach was conducted following the standard operational specifications.The clinical data of the two groups were compared and analyzed.Such as Surgical related indicators(Operation time,Intraoperative blood loss,Time to get out of bed,Postoperative hospital stay),Postoperative complications(Incision infection,scrotal and subcutaneous emphysema,scrotal hematoma,urinary retention,foreign body feeling induration),Postoperative follow-up(Postoperative recurrence,Chronic pain),to observe the clinical effect and application value of laparoscopic free vas deferens(uterine round ligament,URL)for separation of inguinal hernia of the peritoneum.Results: The operations of the two groups of patients were completed under laparoscopic monitoring without transit laparotomy.There were no significant differences in amount of bleeding,out bed activity time,hospital stay,postoperative complications such as incision infection,scrotal and subcutaneous emphysema and urinary retention the between the two groups(P> 0.05).But there were significant differences between the two groups in operation time and number of cases with Induration of foreign substances at the groin area(P<0.05).However,the operation time of LFVD-TAPP approach was significantly shorted with the increase of cases using the LFVD-TAPP approach,closing to that of TAPP after 50 cases.The incidence of scrotal hematoma and postoperative chronic pain were lower in patients subject to LFVD-TAPP approach than TAPP(P<0.05),There was significant difference between the two groups.Conclusions: LFVD-TAPP is a clinical application of the effect and further explore the value of the new surgery,On the basis of the current laparoscopic inguinal hernia repair,such as the advantages of TAPP,reducing the separation operation and thus reduce the difficulty of surgery and conducive to protection of vas deferens,prevention of postoperative scrotal hematoma and other complications.