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改良完全腹膜外入路：既往腹腔镜腹膜前补片修补术后复发性切口疝的最佳可用选择。

Enhanced view totally extraperitoneal approach: The best available option for recurrent incisional hernias following previous laparoscopic intraperitoneal onlay mesh plus repairs.

作者信息

Shenoy K Ganesh

机构信息

Department of Minimal Access, GI and Bariatric Surgery, Fortis Hospital, Bengaluru, Karnataka, India.

出版信息

J Minim Access Surg. 2025 Apr 1;21(2):217-222. doi: 10.4103/jmas.jmas_152_24. Epub 2024 Oct 9.

DOI:10.4103/jmas.jmas_152_24
PMID:39388123
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12054960/
Abstract

The available options for recurrent incisional hernias (RIH) following previous laparoscopic intraperitoneal onlay mesh (IPOM) plus were open onlay repair, open Rives-Stoppa (RS), laparoscopic enhanced view totally extraperitoneal-RS (ETEP-RS) and laparoscopic subcutaneous onlay mesh repair. Majority of these RIH were managed by open onlay mesh repairs or laparoscopic Redo IPOM plus. There are not much data available in the literature on the ETEP approach for RIH following previous IPOM plus with the placement of mesh in the retrorectus space. In this article, I would like to share technical aspects, challenges faced and tips to overcome these challenges of performing ETEP for RIH following previous IPOM plus repairs.

摘要

既往腹腔镜腹腔内补片植入术（IPOM）后复发性切口疝（RIH）的可用治疗方法包括开放补片修补术、开放Rives-Stoppa（RS）修补术、腹腔镜增强视野完全腹膜外-RS（ETEP-RS）修补术和腹腔镜皮下补片修补术。这些复发性切口疝大多采用开放补片修补术或腹腔镜再次IPOM+修补术治疗。关于既往IPOM+术后复发性切口疝采用ETEP方法并将补片放置在腹直肌后间隙的相关文献资料不多。在本文中，我想分享既往IPOM+修补术后复发性切口疝行ETEP手术的技术要点、面临的挑战以及克服这些挑战的技巧。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbaa/12054960/7cc536074b1e/JMAS-21-217-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbaa/12054960/5b83c8d661bd/JMAS-21-217-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbaa/12054960/7cc536074b1e/JMAS-21-217-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbaa/12054960/5b83c8d661bd/JMAS-21-217-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbaa/12054960/7cc536074b1e/JMAS-21-217-g002.jpg

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本文引用的文献

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J Abdom Wall Surg. 2022 Nov 17;1:10634. doi: 10.3389/jaws.2022.10634. eCollection 2022.
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J Minim Access Surg. 2023 Apr-Jun;19(2):223-226. doi: 10.4103/jmas.jmas_225_22.
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Case Rep Surg. 2019 Jul 15;2019:1609193. doi: 10.1155/2019/1609193. eCollection 2019.
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Laparoscopic ventral hernia repair with composite mesh: Analysis of risk factors for recurrence in 185 patients with 5 years follow-up.腹腔镜下腹膜前疝修补术复合补片：5 年随访 185 例患者复发的危险因素分析。
Int J Surg. 2017 Apr;40:38-44. doi: 10.1016/j.ijsu.2017.02.016. Epub 2017 Feb 20.
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Hernia. 2016 Feb;20(1):85-99. doi: 10.1007/s10029-015-1399-9. Epub 2015 Jul 5.
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