To study the clinical efficacy of laparoscopic supraclavicular myofascial space separation in totally extraperitoneal hernia repair (TEP).

The ninety patients with inguinal hernia who underwent TEP from November 2015 to July 2017 in Hanzhong City Mianxian Hospital were randomly selected. They were divided into test group and control group according to the random comparison table, with 45 cases in each group. The test group underwent laparoscopic TEP combined with the spatial separation and anatomy of the pubic symphysis of the pubis, while the control group received simple laparoscopic TEP. Immunohistochemical SP method and radioimmunoassay analysis was used to measure matrix metalloproteinase-2 (MMP-2) content and expression of serum tissue in the collagen content medium of the test group (divided into direct inguinal hernia group and indirect inguinal hernia group).

The operation time, eating time, postoperative ambulation time and postoperative hospitalization time after surgery of the test group was lower than the control group, the differences were statistically significant (t=9.012, 4.601, 12.306, 5.235, all P<0.001). The postoperative chronic pain, sensory nerve abnormalities and the incidence of scrotal hematoma in the test group were significantly lower than those in the control group (χ²=2.362, 1.523, 4.987, P=0.017, 0.016, 0.041). There was no incision infection in the two groups. The test group had better surgical efficacy rate than the control group, the difference was statistically significant (χ²=4.106, P=0.019). Compared with the indirect hernia group, the expression of MMP-2 and type Ⅲ collagen in direct hernia group were significantly higher, the content of the type I collagen in direct hernia group was significantly decreased (t=5.321, 4.936, 5.374, P=0.041, 0.021, 0.031).

TEP shows good curative effect, quick recovery and less postoperative complications of laparoscopic observation in surgical space anatomy to establish four spaces in the pubis muscle area, which is worthy of extensive promotion. The effect of MMP-2 on collagen degradation in adult inguinal hernia is related to the formation of adult inguinal hernia.