膜解剖视角再认识腹股沟区解剖

Inguinal anatomy:a new perspective from fascia anatomy

疝和腹壁外科已进入强调解剖层次、组织胚胎的膜解剖时代。根据人体腹腔筋膜"洋葱皮""圆环套圆环"的膜解剖基础,从胚胎发育、前后腹壁整体观、腔镜和开放的角度分析腹股沟区的筋膜结构,试图论述清楚困扰外科医师的腹横筋膜、腹膜外筋膜(脂肪层)、联合腱膜等解剖名词,统一对腹股沟区解剖的认识,以利于疝修补术辨别层次的深浅、避免损失重要脏器,缩短学习曲线、提高手术同质化水平。

Hernia and abdominal wall surgery has entered an era of membrane anatomy which emphasizes anatomy level and tissue embryos. According to the membrane anatomy of abdominal fascia,such as ＂onion skin＂or＂ring over ring＂,the fascia structure of groin area was analyzed via embryology,holistic view of anterior and posterior abdominal wall,and laparoscopic and open perspective. Attempt to clarify the anatomical terms,such as transversalis fascia,extraperitoneal fascia,conjoint fascia,so as to unify the understanding of groin anatomy,to facilitate distinguish the depth of dissection,to avoid iatrogenic organs injury,to shorten the learning curve,and to improve the homogenization level of sugery.