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食管裂孔疝修补:从索雷里到达芬奇的一个世纪。

Hiatal Hernia Repair: A Century Between Soresi and da Vinci.

机构信息

Department of Surgery, Weill Cornell Medicine, 525 East 68th Street, Box 294, New York, NY 10065, USA.

Department of Surgery, Weill Cornell Medicine, 525 East 68th Street, Box 294, New York, NY 10065, USA.

出版信息

Surg Clin North Am. 2025 Feb;105(1):125-142. doi: 10.1016/j.suc.2024.06.010. Epub 2024 Sep 6.

Abstract

A minimally invasive approach is the most common technique for hiatal hernia repair. The robotic platform offers a unique advantage that addresses the limitations of a laparoscopic repair. The steps of a robotic hiatal hernia repair include reduction of hernia contents, dissection of hernia sac, circumferential dissection of esophagus with 2.5 to 3 cm of intraabdominal esophagus, crural closure, and partial or complete fundoplication. The robotic hiatal hernia repair has comparable perioperative outcomes to the laparoscopic approach. This article discusses current controversies, limitations, and new technologies.

摘要

微创方法是治疗食管裂孔疝最常用的技术。机器人平台具有独特的优势,可以克服腹腔镜修复的局限性。机器人食管裂孔疝修复术的步骤包括疝内容物的复位、疝囊的解剖、食管 2.5 至 3 厘米的腹腔内食管的环形解剖、裂孔闭合以及部分或完全胃底折叠术。机器人食管裂孔疝修复术的围手术期结果与腹腔镜方法相当。本文讨论了当前的争议、局限性和新技术。

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