Surgical strategy for perietalization of round ligament of uterus in female transabdominal preperitoneal technique

Objective: This study aims at identifying an optimal surgical technique for perietalization of round ligament of uterus in female transabdominal preperitoneal( TAPP) cases. Methods: Medical record and operation videos of female TAPP cases in department of general surgery,Qilu Hospital of Shandong University between Nov. 1st 2011 and May 31st 2013 were reviewed retrospectively,clinical data were collected. Particular attention was paid to the procedure of perietalization of round ligament of uterus. A total of 14 female TAPP cases were selected,which included 12 cases of indirect inguinal hernia,1 direct inguinal hernia,1 patient presented both indirect and direct inguinal hernia. Results: The average duration of operation was( 51. 1 ± 18. 4) min,recovery of patients was uneventful. The techniques applied in the perietalization of round ligament of uterus were as follows: 1 dissection the round ligament from peritoneum,2 cut off and 11 incision the peritoneum along the longitudinal axis of round ligament. The latter technique had advantage in easy procedure,keeping integrity of round ligament and peritoneum. The operation procedures of all patients were successful and no post-operative complications were found such as recurrence and chronic pain in follow-up. Conclusions: With regard to strong clinical practicability and short learning curve,superiority of technique of dissecting the peritoneum along the longitudinal axis of round ligament of uterus is obvious compared with dissection and cutting off. The prospect of clinical application and popularization is satisfying.