Abstract:

Comtemporary isssues, controversies and solutions of laparoscopic treatment for incisional hernia        YUE Fei,LI Jian-wen. Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Centre, Shanghai 200025,China
Corresponding author: LI Jian-wen, E-mail：ljw5@yeah.net  
Abstract    Laparoscopic inicisional hernia repair has witnessed a quarter century’s develeopment since its debut in 1993. The representative procedure IPOM has being expanded across the world rapidly due to simpler technique and less complications. With the optimization of defect closure and mesh fixation, and the breakthrough in boundary incisional hernias, laparoscopic incisional hernia repair become a well-acknowledged solution. As the consequences of material limitaions, intraperitoneal mesh related complications emerged with time goes by. Hernia specialists adjust the therapeutic strategy from intraperitoneal to extraperitoneal. However, the new techniques, such as MILOS and etc., are also encountering challenges and controversies. More clinical practice are still required for further evaluation.  

Key words: laparoscope, abdominal wall, incisional hernia, hernia repair, mesh

摘要：

腹腔镜腹壁切口疝修补术从1993年诞生迄今，已发展25年。最初因为技术操作相对简便，切口相关并发症少，代表性术式腹腔内补片平铺术（IPOM）获得迅速推广。随着缺损关闭和补片固定等核心技术问题的逐步优化，以及在边缘切口疝领域的突破，腹腔镜腹壁切口疝修补术更是极受推崇。但因为补片材料学等因素的限制，置于腹腔内的补片随着时间的推移开始出现相关的并发症，疝外科专科医师的治疗策略开始逐步从“腹腔内”走向“腹腔外”。但以MILOS为代表的新技术同样充满了问题与争议，是否会成为革命性的转折点，尚有待于进一步的临床实践检验。

关键词: 腹腔镜, 腹壁, 切口疝, 疝修补术, 补片