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腹腔镜全腹膜外肌后修补术治疗腹壁切口疝的解剖特点和技术要点

吴卫东 李健文 乐飞

中国实用外科杂志2026,Vol.46Issue(4):430-436,7.
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中国实用外科杂志2026,Vol.46Issue(4):430-436,7.DOI:10.19538/j.cjps.issn1005-2208.2026.04.07

腹腔镜全腹膜外肌后修补术治疗腹壁切口疝的解剖特点和技术要点

Anatomical characteristics and technical points of endoscopic totally extraperitoneal retromuscular repair for ventral hernia

吴卫东 1李健文 2乐飞2

作者信息

  • 1. 上海交通大学医学院附属第一人民医院普外科,上海 200080
  • 2. 上海交通大学医学院附属瑞金医院普外科,上海 200025
  • 折叠

摘要

Abstract

Endoscopic totally extraperitoneal retromuscular repair represents an emerging minimally invasive approach for ventral and incisional hernia,adhering to the dual principles of plane-oriented dissection and minimally invasion.Enhanced-view totally extraperitoneal repair is currently the most widely accepted nomenclature.The core concept of this technique lies in achieving continuity of the retromuscular and extraperitoneal space under an optimized endoscopic enhanced-vision.A comprehensive understanding of surgical approaches and anatomical planes is fundamental to procedural success.Commonly adopted approaches include the midline,lateral,and ipsilateral approach,while the surgical planes could be categorized into the pre-sheath plane and the retro-sheath plane.The pre-sheath plane contains multiple tendinous intersections and aponeurotic partitions;therefore,meticulous anatomical dissection is required to balance adequate exposure,avoidance of excessive dissection,and restoration of anatomical structure,thereby preserving the biomechanical stability of the abdominal wall.In contrast,the retro-sheath plane lacks tendinous structures but encompasses areas of fascial convergence where tissue layers are thin and closely adherent,conferring a higher risk of peritoneal injury and directly influencing operative success rates.

关键词

腹腔镜/全腹膜外/肌后修补/腹壁切口疝/解剖特点

Key words

laparoscopy/totally extraperitoneal/retromuscu-lar repair/ventral hernia/anatomical characteristics

分类

医药卫生

引用本文复制引用

吴卫东,李健文,乐飞..腹腔镜全腹膜外肌后修补术治疗腹壁切口疝的解剖特点和技术要点[J].中国实用外科杂志,2026,46(4):430-436,7.

基金项目

Shanghai Oriental Talents Program-Young Project(No.QNJY2024010) 上海市东方英才计划青年项目(No.QNJY2024010) (No.QNJY2024010)

中国实用外科杂志

1005-2208

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