下腹部腹膜前间隙辨析-鞘后视野下的膜解剖  

Anatomic analysis of lower abdomen preperitoneal space:membrane anatomy via posterior sheath vision

作　　者：张一忠 蒋会勇 吴卫东[3] Zhang Yizhong;Jiang Huiyong;Wu Weidong(Hernia and Abdominal Wall Surgery,Affiliated Hospital of Ningbo University,Ningbo 315000,Zhejiang Province,China;Second Department of General Surgery,Northeast International Hospital,Shenyang 110015,China;Department of General Surgery,Shanghai General Hospital,Shanghai 200080,China)

机构地区：[1]宁波大学医学院附属医院疝与腹壁外科,浙江省315000 [2]中一东北国际医院普外二科,沈阳110015 [3]上海交通大学医学院附属第一人民医院·上海市第一人民医院普外科,200080

出　　处：《中华疝和腹壁外科杂志（电子版）》2022年第4期394-400,共7页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的进一步认识下腹部的膜解剖,印证部分解剖结构的认识。方法2020年1月至2021年6月完成281例后鞘后入路单孔腹腔镜完全腹膜外疝修补术(TEP)手术,从后鞘后的角度来观察下腹部腹膜前的膜解剖结构。通过手术视频、照片以及对文献的检索与溯源,来进一步描述手术中观察到的解剖结构。结果腹直肌后筋膜独立存在,腹横筋膜(TF)源自侧方扁肌,存在三种不同类型,气腹状态下TF为单层立体结构,髂耻束是TF的延续。结论鞘后视野的发现进一步印证部分解剖认识,有助于理解下腹部膜解剖。Objective To further understand the membrane anatomy of the lower abdomen preperitoneal space and verify several understandings of preperitoneal space anatomy.Methods From January 2020 to June 2021,281 cases of single incision laparoscopic totally extraperitoneal(TEP)utilizing the posterior sheath approach were performed.The membrane anatomical structure of lower abdomen was observed from the perspective of the posterior sheath.The anatomical structures observed during surgery were further described through surgical videos,photos and literature review.Results The posterior fascia of rectus abdominis exists independently,the transverse fascia(TF)is derived from the lateral flat muscle,and there are three different types of it.TF is monolayer solid structure on pneumoperitoneum state,and the iliopubic tract is the continuation of TF.Conclusion The discovery of the posterior sheath field further verified some anatomy understandings and may be contributed to the understanding of lower abdomen preperitoneal space membrane anatomy.

关 键 词：后鞘后 膜解剖 腹横筋膜 腹直肌筋膜 腹膜前筋膜 弓状线 髂耻束 

分 类 号：R656.2[医药卫生—外科学]