内镜下全内脏囊分离技术: 腹壁疝微创新理念

Endoscopic totally visceral sac separation:a novel concept for ventral hernia

人体腹壁是一个生理功能的整体,由不同解剖结构与层次构成。在腹壁不同部位,可采用不同的外科技术或手术入路。腹壁的几处解剖隔断将腹壁的解剖空间相互分隔,打开解剖隔断,连通各处组织空间,就能创造出巨大的腹直肌后及腹膜外间隙,从而实现全内脏囊分离技术。笔者从腹壁的解剖分区、腹膜在全内脏囊分离技术中的解剖意义以及腹壁不同解剖分区全内脏囊分离技术的细节与注意事项进行探讨。

The whole abdominal wall can be regarded as a physiological and functional entity which is composed of multiple anatomical structures and layers.Surgical approaches or techniques are differently required for different portions of the abdominal wall.Indeed,the abdominal wall is confined by several anatomical boundaries which make different surgical spaces disconnected.If these boundaries could be broken down,separated spaces are now connected,establishing an ample retromuscular/preperitoneal space to perform totally visceral sac separation.The author has investigated the anatomical portions,significance of abdominal wall in totally visceral sac separation,and technical details and notes of totally visceral sac separation for different portions of abdominal wall in this paper.