腹腔镜全腹膜外肌后修补术秉承层次和微创双重优先理念，是治疗腹壁切口疝的新兴微创术式。增强视野全腹膜外修补术是其较公认的统一称谓，术式核心是在增强视野下完成肌后和腹膜外间隙的贯通。不同入路、不同层面的解剖认知是手术成功的关键保障。临床常用入路包括中央入路、侧方入路、同侧入路，解剖层次可分为鞘前、鞘后层面。鞘前层面存在多种腱性分隔，手术需在精准解剖、避免过度分离、结构重建之间达成最佳平衡，维护腹壁力学稳定性。鞘后层面无腱性结构，但存在组织汇合区域，各层次菲薄粘连，腹膜破损风险高，直接影响手术成功率。

Endoscopic totally extraperitoneal retromuscular repair represents an emerging minimally invasive approach for ventral and incisional hernia, adhering to the dual principles of plane-oriented dissection and minimally invasion. Enhanced-view totally extraperitoneal repair is currently the most widely accepted nomenclature. The core concept of this technique lies in achieving continuity of the retromuscular and extraperitoneal space under an optimized endoscopic enhanced-vision. A comprehensive understanding of surgical approaches and anatomical planes is fundamental to procedural success. Commonly adopted approaches include the midline, lateral, and ipsilateral approach, while the surgical planes could be categorized into the pre-sheath plane and the retro-sheath plane. The pre-sheath plane contains multiple tendinous intersections and aponeurotic partitions; therefore, meticulous anatomical dissection is required to balance adequate exposure, avoidance of excessive dissection, and restoration of anatomical structure, thereby preserving the biomechanical stability of the abdominal wall. In contrast, the retro-sheath plane lacks tendinous structures but encompasses areas of fascial convergence where tissue layers are thin and closely adherent, conferring a higher risk of peritoneal injury and directly influencing operative success rates.