腹腔镜腹壁切口疝修补术的现状和展望

Current status and prospects of laparoscopic ventral/incisional hernia repair

开放腹膜前修补术(sublay)和腹腔镜腹腔内修补术(IPOM)是治疗腹壁切口疝的主要术式,各类腔镜非腹腔内修补术(MINIM)目前处于探索阶段,未来有较大的进展空间。IPOM和MINIM术式具有不同的修补理念、技术特点和适应人群,严格把握手术指证,可以最大程度体现各自的优势。现代疝外科更注重"微创"和"腹壁功能重建",在修复腹壁缺损、恢复腹壁功能的同时,尽可能减少腹壁的过度分离。随着新材料的研发、新技术的探索和腔镜平台的升级换代,基于微创理念的腹腔切口疝修补术会拥有更广阔的前景。

Open retromuscular (sublay) repair and laparoscopic intraperitoneal onlay mesh (IPOM) technique are the main procedures for ventral/incisional hernia repair.All types of minimally non-intraperitoneal mesh (MINIM) repair are currently still in the exploration stages,which may have wide development prospects in the future.IPOM and MININ have different repair concepts,technical characteristics and targeted patient populations.Under strict indication control,both procedures can show their respective advantages to the greatest extent.Modern hernia surgery emphasizes "minimal invasion" and "reconstruction of abdominal wall function".While repairing the defects of abdominal wall and restoring abdominal wall function,surgeons should minimize excessive dissection of abdominal wall.With the development of new materials,the exploration of new technologies and the upgrading of endoscopic platforms,the ventral/incisional hernia repair based on the minimally invasive concept will witness a more promising future.