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目的 总结腹腔镜下完全腹膜外疝修补术(totally extraperitoneal prosthetic repair,TEP)腹膜前间隙的临床建立体会. 方法 回顾性分析2014年1月~2015年1月我院腹腔镜下行TEP术的154例腹股沟疝患者的临床资料.单侧疝144例,双侧疝10例.斜疝120侧,直疝36侧,股疝8侧,术中证实为复合疝7例.腹股沟疝分型:Ⅰ型35例,Ⅱ型71例,Ⅲ型34例,Ⅳ型14例. 结果 本组共施行腹腔镜下TEP 154例(164侧),均顺利完成手术.单侧手术时间平均32.5 (20~65) min.术中未发生大出血、输精管损伤等.术后发生并发症13例,其中6例为腹股沟区血清肿,均经穿刺引流后治愈.6例脐部切口愈合延迟.术后第2d复发1例,再次手术后治愈.出院后电话或门诊随访149例(96.8%),随访7.5(1~13)个月,未发生补片感染、慢性疼痛、睾丸萎缩等并发症. 结论 腹膜前间隙层次空间的正确创建是腹腔镜TEP手术成功、降低术后并发症发生率的关键.“,”Objective To summarize the clinical experience on the preperitoneal space creation during laparoscopic totally extraperitoneal inguinal hernia repair (TEP).Methods The clinical data of 154 inguinal hernia patients treated by laparoscopic TEP surgery were analyzed retrospectively during January 2014 to January 2015,including 144 cases of unilateral hernia and 10 cases of bilateral hernia.There was indirect hernia in 120 laterals,direct hernia in 36 laterals,femoral hernia in 8 laterals.The inguinal hernia was type Ⅰ in 35 cases,type Ⅱ in 71 cases,type Ⅲ in 34 cases and type Ⅳ in 14 cases.Results All 154 cases with 164 laterals were accomplished the laparoscopic TEP successfully.The unilateral operation time was 20 to 65 minutes with an average 32.5 minutes.No intraoperative bleeding and deferent duct injury were found.Postoperative complications occurred in 13 cases:Inguinal region seroma in 6 cases,and cured after puncture drainage,navel incision delayed healing in 6 cases,and recurrence in 1 cases within two days after surgery and cured by reoperation.149 cases were followed up for 1 to 13 months(means,7.5 moths).No complications such as patch infection,chronic pain and testicular atrophy were found.Conclusion The correct creation of preperitoneal space is the key to certify the laparoscopic TEP success and reduce the postoperative complication.