Abstract: Objective To compare the clinical efficacy of laparoscopic total extraperitoneal hernia repair based on different anatomical sites.
Methods The Clinical data of 82 patients with inguinal hernia who underwent totally extraperitoneal hernia repair(TEP) in our hospital from February 2019 to April 2020 were collected for retrospective analysis.According to the TEP operation under different anatomy,all the patients were divided into two groups with 41 patients in each group.Group A was given membrane dissection under laparoscopic total extraperitoneal hernia repair,group B line based on the anatomy of the peritoneal clearance before laparoscopic total extraperitoneal hernia repair.The operative time,intraoperative blood loss,recovery time of restricted activities,length of stay,rate of conversion to open surgery,rate of postoperative recurrence,and incidence of complications related to urinary retention,intestinal obstruction,seroma,and scrotal edema were analyzed and compared between the two groups.
Results The time of operation,the amount of bleeding during operation,the time of recovery of restrictive activity and the time of hospitalization in group A were significantly shorter than those in group B,the difference was statistically significant(P＜0.05).There was no significant difference in VAS score within 12 hours after operation between the two groups,and the VAS score in group A was significantly lower than that in group B at 24 hours,48 hours,7 days and 15 days after operation,the difference was statistically significant(P<0.05).After 30 days,the pain of the two groups basically disappeared;the rate of conversion to open surgery and postoperative complications in group A were significantly lower than those in group B,the difference was statistically significant(P＜0.05).
Conclusion Mastering the anatomy of inguinal region membrane is helpful to improve the safety of laparoscopic total extraperitoneal hernia repair,shorten the operation time,reduce the recurrence rate and postoperative complications.

Key words: membrane anatomy, anatomy of the preperitoneal space, laparoscope, hernia repair, clinical curative effect