机器人辅助腹腔镜下食管裂孔疝修补术的应用进展

Application progress of robot-assisted laparoscopic hiatal hernia repair

食管裂孔疝(HH)是一种影响着多达60%的成年人口的常见疾病,高龄和超重是HH发生的主要危险因素。近年来,HH的发生率有增加趋势,因此防治变得至关重要。腹腔镜下HH修补术是目前治疗有症状的HH的主要方式。但是传统腹腔镜技术具有视野受限、器械运动受限、二维成像以及外科医师学习曲线长等缺点。近年来,机器人手术平台克服了传统腹腔镜手术相关的一些技术限制,在HH修补中的使用有所增加。机器人辅助腹腔镜下HH修补术能够减少转换为开放手术的需要,缩短患者住院时间,降低术后并发症发生率,精细解剖和缝合,初始学习曲线短。此外,机器人辅助可能有利于HH修补和抗反流手术后的再次手术,有望成为复发性HH的首选术式。本文中笔者对机器人辅助腹腔镜下食管裂孔疝修补术的应用进展进行综述,旨在为其临床应用推广提供参考。

Hiatal hernia(hiatal hernia,HH)is a common disease that affects up to 60%of the adult population.Old age and overweight are the main risk factors for HH.In recent years,as the number of overweight people has increased and the phenomenon of aging has become more and more prominent,the prevention and treatment of HH has become crucial.Laparoscopic HH repair is the main way to treat symptomatic HH.However,traditional laparoscopic techniques have the disadvantages of limited field of view,limited movement of instruments,2-dimensional view,slow learning curve for surgeons and so on.In recent years,the use of robotic surgery platforms in HH repair has increased because it can overcome some of the technical limitations associated with traditional laparoscopic surgery.Robot-assisted laparoscopic HH repair has the following potential advantages:it can reduce the need to switch to open surgery;it can shorten the patient's hospital stay;it has lower postoperative complications;It has advantages in fine anatomy and suture;and The initial learning curve appears relatively short for experienced minimally invasive esophageal surgeon.In addition,robot assistance may be beneficial for Redo hiatal hernia and antireflux surgery,and is expected to become the first choice for recurrent HH.This article reviews the clinical application and progress of robot-assisted laparoscopic hiatal hernia repair.