Dewulf Maxime, Dietz Ulrich A, Montgomery Agneta, Pauli Eric M, Marturano Matthew N, Ayuso Sullivan A, Augenstein Vedra A, Lambrecht Jan R, Köhler Gernot, Keller Nicola, Wiegering Armin, Muysoms Filip
Department of Surgery, Maastricht University Medical Center, Maastricht, Niederlande.
Department of Visceral, Vascular and Thoracic Surgery, Cantonal Hospital Olten, Olten, Schweiz.
Chirurgie (Heidelb). 2022 Nov;93(11):1051-1062. doi: 10.1007/s00104-022-01715-7. Epub 2022 Oct 10.
The surgical treatment of parastomal hernias is considered complex and is known to be prone to complications. Traditionally, this condition was treated using relocation techniques or local suture repairs. Since then, several mesh-based techniques have been proposed and are nowadays used in minimally invasive surgery. Since the introduction of robot-assisted surgery to the field of abdominal wall surgery, several adaptations to these techniques have been made, which may significantly improve patient outcomes. In this contribution, we provide an overview of available techniques in robot-assisted parastomal hernia repair. Technical considerations and preliminary results of robot-assisted modified Sugarbaker repair, robot-assisted Pauli technique, and minimally invasive use of a funnel-shaped mesh in the treatment of parastomal hernias are presented. Furthermore, challenges in robot-assisted ileal conduit parastomal hernia repair are discussed. These techniques are illustrated by photographic and video material. Besides providing a comprehensive overview of robot-assisted parastomal hernia repair, this article focuses on the specific advantages of robot-assisted techniques in the treatment of this condition.
造口旁疝的外科治疗被认为是复杂的，并且已知容易出现并发症。传统上，这种情况采用重新定位技术或局部缝合修复进行治疗。从那时起，已经提出了几种基于补片的技术，如今在微创手术中使用。自从机器人辅助手术引入腹壁外科领域以来，对这些技术进行了一些改进，这可能会显著改善患者的治疗效果。在本论文中，我们概述了机器人辅助造口旁疝修补术中可用的技术。介绍了机器人辅助改良Sugarbaker修补术、机器人辅助Pauli技术以及在造口旁疝治疗中微创使用漏斗形补片的技术要点和初步结果。此外，还讨论了机器人辅助回肠造口旁疝修补术中的挑战。这些技术通过照片和视频资料进行说明。除了全面概述机器人辅助造口旁疝修补术外，本文还重点介绍了机器人辅助技术在治疗这种疾病方面的具体优势。
