无张力无缝合原发性腹股沟疝修补术：Trabucco技术-3

当外侧斜腱膜在精索后方闭合时，腹股沟环不应重叠。向深腹股沟环外侧移动T4塞或向耻骨结节方向移动预成形网片可防止腹股沟环重叠并保持腹股沟管倾斜。例如，在一个7厘米长的内侧盒子里，精索向内侧拉1厘米，它从预先成形的假体孔中伸出腹股沟深环1厘米，与耻骨结节重叠1厘米[2]。

图2.12 腹股沟箱中预成形网片的最终视图（E.E.Trabucco提供的原始图纸）[1，2]

图2.13 腹股沟腔植入聚丙烯预成形网片的术中最终视图

图2.14 精索下外侧斜腱膜闭合术（E.E.Trabucco提供的原始图纸）[1，2]

图2.15 前腹壁上叠加的预成形网片（E.E.Trabucco提供的原始图纸）[1，2]

外侧斜腱膜在网片上方、精索下方闭合，手术完成。（图2.14和2.15）。

参考资料：

1.Trabucco EE (199S) The office hernioplasty and the Trabucco repair. Ann It Chir 44:127–149

2.Trabucco EE, Trabucco AF (1998) Flat plug and mesh hernioplasty in the “inguinal box”: description of the surgical technique. Hernia 2:133–138

3. Campanelli G, Cioffi U, Cavagnoli R et al (1999) Open sutureless tension-free repair for primary inguinal hernia. Hernia 3:121–124

4.Trabucco EE, Trabucco AF, Rollino R et al (1998) Ernioplastica inguinale tension-free con rete presagomata senza suture secondoTrabucco. Minerva Chir 11:142–148

5.Petruzelli L (1999) Utilization of a rigid pre-shaped mesh according to the Trabucco technique: an experimental study. In: National Congress of SICADS. Ambulatory Surgery in Italy, Rome

6.Trabucco EE, Campanelli G, Cavagnoli R (1998) Nuove protesi erniarie in polipropilene. Minerva Chir 53:337–342

7.Amid PK (1987) Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1:15–21

8.Alfieri S, Amid PK, Campanelli G et al (2011) International guidelines for prevention    and management of post-operative chronic pain following inguinal hernia surgery. Hernia 15:239–249

9.Campanelli G, Cavagnoli R, Gabrielli F et al (1995) Trabucco’s procedure and local anaesthesia in surgical treatment of inguinal and femoral hernia. Int Surg 80:29–34

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