女性腹腔镜腹股沟疝修补术子宫圆韧带的处理方式

Handling methods of uterus round ligament in laparoscopic inguinal hernia repair in females

  • 摘要: 腹腔镜腹股沟疝修补术已被广泛应用于成人腹股沟疝的治疗中。男性患者精索为重要生殖器官,为防止影响其生育能力,术中应将精索去腹膜化避免损伤。在女性患者中,腹股沟管内走行的并非精索而是子宫圆韧带,其由腹膜内逐渐伸展到腹膜外,经过腹膜时与腹膜结合紧密,术中将子宫圆韧带与腹膜完整剥离以达到“去腹膜化”的难度较大,因此,术中如何处理子宫圆韧带仍存在较大争议。国内外对于腹腔镜腹股沟疝修补术中子宫圆韧带的处理方式尚无统一的指导性文件,笔者总结相关文献,就女性腹腔镜腹股沟疝修补术子宫圆韧带的处理方式进行探讨。

     

    Abstract: Laparoscopic inguinal hernia repair has been widely used in adult inguinal hernia. The spermatic cord, as an important reproductive organ in male patients, should be deperitonealized to avoid injury in order to prevent fertility from being affected. However in female patients, the uterine round ligament not the spermatic cord goes across the inguinal canal, which extends from intraperitoneal and extraperitoneal, banding tightly with the peritoneum. It is difficult to completely strip the uterus round ligament from peritoneum to achieve deperitonealization. Hence there is still controversy about how to handle the uterus round ligament. There is no uniform guidance document for the handling of the uterus round ligament in laparoscopic inguinal hernia repair around the world. Handling methods are investigated in this article based on the summary of related literatures.

     

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