腹股溝疝修補及產(chǎn)品知識 - Day2

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(xué)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(jìn)入打開腹股溝管Posterior-后入路Fromtheinsideout從疝囊后方進(jìn)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(yù)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(yù)裁補片SpermaTex01147003"x6"(7.6cmx15.2cm),(帶ePTFE精索保護(hù)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(yù)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(zhǔn)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(fù)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