Donkor Charan, Gonzalez Anthony, Gallas Michelle R, Helbig Michael, Weinstein Corey, Rodriguez Jaime
Department of General and Bariatric Surgery, Baptist Health South Florida, Miami, FL, USA,
Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA,
Robot Surg. 2017 May 5;4:57-67. doi: 10.2147/RSRR.S101809. eCollection 2017.
The surgical treatment of hernias has developed throughout the evolution of surgery. The fascination with hernia surgery is in part driven by its prevalence and by the variety of treatment options. Minimally invasive hernia surgery has a goal of a robust repair with minimal complications, and new robotic techniques are being developed in complex abdominal wall hernias with promising results. This review focuses on inguinal, ventral, and incisional hernias and their outcomes with a discussion on the traditional open, laparoscopic, and robotic techniques. The prevalence of minimally invasive hernia surgery and its advantages are also outlined. We highlight our experience in these procedures, specifically robotic herniorrhaphy, as it pertains to ventral incisional and inguinal hernia repair. We conclude that the robotic platform is proving to be a benefit to hernia repair. Many studies are showing its feasibility and comparable results to standard laparoscopy, and some have shown improved results, including shorter hospital stay without significant increases in cost. The robotic option of hernia repair has resulted in an increase in minimally invasive hernia repair, a number that has remained stagnant for the last decade. With more surgeons gaining training and experience and greater availability of the robotic platform, we expect to see greater numbers of minimally invasive hernia repair.
疝的外科治疗随着外科手术的发展而不断演进。对疝手术的关注部分源于其高发性以及多种治疗选择。微创疝手术的目标是实现牢固修复且并发症最少，目前针对复杂腹壁疝正在研发新的机器人技术，且已取得了令人鼓舞的成果。本综述聚焦于腹股沟疝、腹疝和切口疝及其治疗效果，并探讨传统开放手术、腹腔镜手术和机器人手术技术。文中还概述了微创疝手术的普及情况及其优势。我们着重介绍了我们在这些手术中的经验，特别是机器人疝修补术在腹切口疝和腹股沟疝修补中的应用。我们得出结论，机器人平台已被证明对疝修补有益。许多研究表明其可行性以及与标准腹腔镜手术相当的效果，还有一些研究显示效果有所改善，包括缩短住院时间且成本无显著增加。疝修补的机器人手术方式使微创疝修补的数量有所增加，而在过去十年中这一数字一直停滞不前。随着越来越多的外科医生接受培训并积累经验，以及机器人平台的更广泛应用，我们预计会有更多的微创疝修补手术。
