Two hundred endoscopic extraperitoneal inguinal hernioplasties: cost containment by reusable instruments

作     者：LAU Hung ,LEE Francis ,PATIL Nivritti-Gajanan ,YUEN Wai-Key 

出 版 物：《中华医学杂志(英文版)》 (Chinese Medical Journal)

年 卷 期：2002年第6期

页      面：88-91页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：inguinal hernia · herniorrhaphy · laparoscopy 

摘      要：Objective To report our experience of 200 endoscopic totally extraperitoneal inguinal hernioplasties utilizing reusable *** Between August 1999 and June 2000, 200 endoscopic totally extraperitoneal hernioplasties were performed on 163 patients. The mean age of the study population was 63 years with a male to female ratio of 157∶6. Perioperative details and postoperative outcomes were prospectively evaluated and *** A total of 196 (98%) endoscopic extraperitoneal inguinal hernioplasties were successfully performed. Conversion rates to transabdominal preperitoneal and open repairs were 1.5% (n=3) and 0.5% (n=1), respectively. There were no other intraoperative complications. Postoperative morbidity included retention of urine (n=7), wound bruising (n=2), atelectasis (n=2) and gouty arthritis (n=1). The mean visual analogue pain scores at rest were 2.3, 1.6 and 1.9 on postoperative days 0, 1 and 2, respectively. The mean length of hospital stay was 1.9 days. 113 patients (69%) returned to normal activities within one week. Of the 35 patients who experienced both open and laparoscopic repair, 80% expressed preference for endoscopic hernioplasty in the event of future *** Endoscopic extraperitoneal inguinal hernioplasty can be safely performed utilizing reusable trocars. Substantial reduction of operative cost could be achieved by the elimination of disposable instruments. Deficiencies of the reusable metallic trocar, namely peri-cannula air-leak and sliding movements of the trocar, can be overcome by purse-string suture of the fascial opening.