内镜下Sublay修补术的再认识

Re-recognition of endoscopic Sublay repair

腹壁疝的修补技术处于动态发展中,目前有确切证据的腹壁疝修补术仍是腹腔镜腹腔内补片植入术(IPOM)和开放Sublay修补术,组织结构分离术的应用进一步拓宽了IPOM和Sublay修补术治疗巨大腹壁疝的适应证。笔者认为:内镜下Sublay修补术理论上结合了开放Sublay修补术和腹腔镜IPOM的优点,但该手术方式具有医源性破坏肌腱间隔的正常力学结构等缺点,需严格规范适应证和进一步深入研究。

Repair of abdominal hernia is in dynamic evoluation.Laparoscopic intra-peritoneal onlay mesh(IPOM)and open Sublay repair are still the best methods for the repair of abdominal wall hernia.The application of component separation technique has further widened the indications of IPOM and Sublay repair for the treatment of large abdominal wall hernia.Endoscopic Sublay technique theoretically combines the advantages of open Sublay repair and laparoscopic IPOM repair,but it has the disadvantages of iatrogenic destruction of the tendon septum and normal mechanical deconstruction,which requires strict specification of indications and further research.