机器人辅助手术治疗复杂腹壁巨大切口疝3例  

Robotic-assisted surgical treatment of complex giant incisional hernias:A report of 3 cases

作　　者：向延东 信嘉轩 刘毅辉 易波[1] XIANG Yandong;XIN Jiaxuan;LIU Yihui;YI Bo(Second Department of Gastroenterology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院胃肠外科Ⅱ科,长沙410013

出　　处：《中南大学学报(医学版)》2024年第10期1700-1705,共6页Journal of Central South University :Medical Science

基　　金：湖南省科学技术厅重点研发计划(2021SK2001)。

摘　　要：腹壁切口疝是开腹手术最常见的并发症之一,其中腹壁巨大切口疝的定义为腹壁缺损最大直径>12 cm或疝囊容积与腹腔容积比>20%。腹壁巨大切口疝的主要治疗方法为手术治疗,开放手术和传统腹腔镜手术治疗难度和手术创伤均较大,术后并发症多,治疗效果不理想。2021年5月至2023年11月中南大学湘雅三医院收治了3例腹壁巨大切口疝的患者,并对其进行了达芬奇机器人辅助下腹腔内补片修补术(robotic-assisted intraperitoneal onlay mesh,rIPOM)。患者术中出血少,术后恢复时间短,未发生切口感染及严重并发症,无再次复发。相较于传统开放手术、腹腔镜手术,机器人辅助手术在腹壁巨大切口疝临床应用上具有独特优势。Incisional hernia of abdominal wall is one of the most common complications following open surgery.Giant incisional hernia of abdominal wall is defined as having a maximum defect diameter>12 cm or a hernia sac volume-to-abdominal cavity volume ratio>20%.The Primary treatment for giant incisional hernia of abdominal wall is surgical repair;however,both open surgery and conventional laparoscopic surgery are associated with significant technical difficulty,high surgical trauma,frequent postoperative complications,and suboptimal outcomes.From May 2021 to November 2023,3 patients with giant incisional hernia of abdominal wall were treated at the Third Xiangya Hospital of Central South University with robotic-assisted intraperitoneal onlay mesh repair using the da Vinci surgical system.These patients experienced minimal intraoperative bleeding,rapid postoperative recovery,no wound infections or severe complications,and no recurrences.Compared with traditional open and laparoscopic surgeries,robotic-assisted surgery demonstrates unique advantages in the clinical management of giant incisional hernias.

关 键 词：腹壁巨大切口疝 机器人辅助手术 疝修补术 达芬奇机器人 补片 腹腔镜手术 

分 类 号：R65[医药卫生—外科学]