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切口疝修补的微创方法。

Minimally invasive approaches to incisional hernia repairs.

作者信息

Phillips Joseph D, Nagle Alexander P

机构信息

Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

出版信息

J Long Term Eff Med Implants. 2010;20(2):117-28. doi: 10.1615/jlongtermeffmedimplants.v20.i2.40.

Abstract

Incisional hernias are a common problem following abdominal surgery, occurring when the intraabdominal contents protrude through a defect created in the abdominal wall. Several advances in the last several decades have resulted in improved outcomes for repairing these hernias. Initially, the advent of prosthetic material allowed the abdominal wall to be closed without tension. The utilization of laparoscopic techniques decreased hospital stays and wound complications. Advances in mesh technology have also aided in treatment strategies and options. However, the perfect mesh has yet to be invented. Further investigation and collaboration are required to create a material that is stable, does not alter the mechanics of the abdominal wall, is resistant to infection, and promotes adequate tissue ingrowth without adhesion or fistula formation. This review describes patient selection, preoperative preparation, mesh selection, surgical techniques, and common complications of minimally invasive approaches to incisional hernias.

摘要

切口疝是腹部手术后常见的问题,当腹腔内容物通过腹壁上形成的缺损突出时就会发生。过去几十年的几项进展使这些疝的修复效果得到了改善。最初,人工合成材料的出现使腹壁能够无张力缝合。腹腔镜技术的应用缩短了住院时间并减少了伤口并发症。补片技术的进步也有助于治疗策略和选择。然而,完美的补片尚未发明出来。需要进一步的研究和合作来制造一种稳定的材料,这种材料不会改变腹壁的力学性能,能抵抗感染,并能促进足够的组织向内生长而不形成粘连或瘘管。这篇综述描述了切口疝微创治疗方法的患者选择、术前准备、补片选择、手术技术和常见并发症。

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