Malik Kashif, Bowers Steven P, Smith C Daniel, Asbun Horacio, Preissler Susanne
Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA.
J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):607-10. doi: 10.1089/lap.2009.0155.
Laparoscopic ventral hernia repair has been shown to offer improved patient recovery, when compared to open repair. It has also been shown to offer a lower complication rate. However, in patients with high body-mass index and large defects, the intraperitoneal on-lay technique of laparoscopic repair is criticized for an increased incidence of failure. In 1990, a study introduced the technique of open-component separation, hence enabling the medialization of the rectus muscle and decreasing the incidence of recurrence associated with primary repair. Open-component separation is associated with increased wound problems due to extensive dissection. Different laparoscopic and endoscopic modifications to the open-component-separation technique have been tried to minimize wound problems. In this article, we present our case series of 4 patients involving the laparoscopic component-separation technique of rectus medialization and, laparoscopic ventral hernia combined. This is one of the first series ever reported to involve both modalities of hernia repair in using an exclusive laparoscopic technique.
与开放修补术相比，腹腔镜腹疝修补术已被证明能使患者恢复得更好。它还被证明具有较低的并发症发生率。然而，对于体重指数高且疝缺损大的患者，腹腔镜修补术中的腹腔内置片技术因失败率增加而受到批评。1990年，一项研究引入了开放成分分离技术，从而实现了腹直肌的内移，并降低了与初次修补相关的复发率。由于广泛的解剖，开放成分分离与伤口问题增加有关。人们尝试了对开放成分分离技术进行不同的腹腔镜和内镜改良，以尽量减少伤口问题。在本文中，我们展示了4例患者的病例系列，这些患者采用了腹腔镜腹直肌内移成分分离技术以及腹腔镜腹疝联合技术。这是有史以来首批报道的仅使用腹腔镜技术同时涉及两种疝修补方式的系列病例之一。
