腹股溝疝疝修補技術(shù)及產(chǎn)品應(yīng)用張苗苗2014-11-16Dr.Bassini-1887技術(shù):

回納疝囊（高位結(jié)扎）將腹內(nèi)斜肌，腱膜以及聯(lián)合肌腱和腹股溝韌帶縫合ConjoinedTendonInternalObliquePTInguinalLigamentBassini手術(shù)Dr.McVay-1942技術(shù):將腹內(nèi)斜肌及腱膜，聯(lián)合肌腱和Cooper‘s韌帶縫合在腹直肌鞘上做減張切口ConjoinedTendonPTInternalObliqueCooper’sLigamentInguinalLigamentRelaxingincision單絲

vs.多絲Whitebloodcells無張力疝修補的力學原理腹股溝疝修補2種入路4個層次5種方法腹股溝疝修補的2種入路Anterior-前入路Fromtheoutsidein從疝囊頂端進入打開腹股溝管Posterior-后入路Fromtheinsideout從疝囊后方進入不打開腹股溝管腹股溝疝修補層次加強腹股溝管后壁的Lichtenstien術(shù)式加強疝環(huán)的Plug手術(shù)腹膜前間隙修補腹腔內(nèi)修補（IPOM）手術(shù)入路開放前入路

-三個層次修補開放后入路-STOPPA，KUGEL，陳雙開放TEP腔鏡后入路-TAPP,TEP常用補片及修補層次前入路后入路Lichtenstien術(shù)式Rutkow術(shù)式Millikan術(shù)式Kugel技術(shù)（開放后入路）改良KugelPHS&UHSTEP加強腹股溝管后壁加強疝環(huán)腹膜前間隙修補TAPPIPOMLichtenstein術(shù)式網(wǎng)塞

-RUTKOW術(shù)式網(wǎng)塞

-MILLIKAN術(shù)式改良KUGEL術(shù)式TAPP術(shù)式Trans-AbdominalPreperitonealApproachTEP術(shù)式TotallyExtra-PeritonealApproach產(chǎn)品應(yīng)用巴德–平片產(chǎn)品描述貨號規(guī)格包裝巴德疝修補平片預裁補片01126401"x4"(2.5cmx10cm)3片/盒01126502"x4"(5cmx10cm)3片/盒011266010"x14"(25cmx35.5cm)1片/盒01126702"x12"(5cmx30.5cm)2片/盒01126803"x6"(7.5cmx15cm)3片/盒01126901"x24"(2.5cmx60cm)2片/盒01127206"x6"(15cmx15cm)3片/盒01127001.8"x4"(4.5cmx10cm)3片/盒01127101.8"x4"(4.5cmx10cm),大號,帶精索開口3片/盒01137002.4"x5.4"(6cmx13.7cm)3片/盒01137102.4"x5.4"(6cmx13.7cm),大號,帶精索開口3片/盒巴德疝修補平片和預裁補片SpermaTex01147003"x6"(7.6cmx15.2cm),(帶ePTFE精索保護墊)3片/盒巴德大網(wǎng)孔輕質(zhì)平片SoftMesh01170085CM×10CM3片/盒01170097.5CM×15CM3片/盒011701010CM×15CM3片/盒011701115CM×15CM3片/盒0117012Pre-shaped4.5CM×10CM3片/盒0117013Pre-shapedwithKeyhole4.5CM×10CM3片/盒0117014Pre-shaped6×13.7CM3片/盒0117015Pre-shapedwithKeyhole6×13.7CM3片/盒產(chǎn)品規(guī)格Lichtenstein術(shù)式BardSoftMesh巴德–輕量平片巴德–網(wǎng)塞外瓣內(nèi)瓣上片-預裁平片-精索孔BARDPerfixPlugBARDPerfixPlug將網(wǎng)塞翻轉(zhuǎn)，根據(jù)疝環(huán)大小，修剪網(wǎng)塞內(nèi)瓣，以適度填充內(nèi)環(huán)為準產(chǎn)品概覽中國大陸目前僅供應(yīng)0117070及0117080兩種型號BardModifiedKugel

最簡單的腹膜前間隙技術(shù)產(chǎn)品規(guī)格

改良Kugel術(shù)式–修復后效果圖后面觀前面觀Bard3DMaxMesh

Bard3DMaxLightMesh產(chǎn)品規(guī)格產(chǎn)品編號規(guī)格尺寸包裝產(chǎn)品描述0115310中號左側(cè)(8.5cmx13.7cm)1片/盒3DMaxMesh0115311大號左側(cè)(10.8cmx16cm)1片/盒0115312特大號左側(cè)(12.4cmx17.3cm)1片/盒0115320中號右側(cè)(8.5cmx13.7cm)1片/盒M0115321大號右側(cè)(10.8cmx16cm)1片/盒0115322特大號右側(cè)(12.4cmx17.3cm)1片/盒0117310中號左側(cè)(7.9cmx13.4cm)1片/盒3DMaxLightMesh0117311大號左側(cè)(10.3cmx15.7cm)1片/盒0117312超大號左側(cè)(12.2cmx17.0cm)1片/盒0117320中號右側(cè)(7.9cmx13.4cm)1片/盒0117321