腹腔镜全内脏囊分离技术体系——治疗腹壁疝的微创新理念

doi:10.16139/j.1007-9610.2026.01.05

摘要/Abstract

摘要：

人体腹壁是生理功能的整体，由不同的解剖结构和层次构成。在腹壁不同部位，可用于疝外科修补理想的解剖层次各不相同。腹壁的解剖隔断将各个解剖空间相互分隔。打开这些解剖隔断，连接各处解剖空间，就能创造出腹壁疝补片修补所需要的巨大的腹直肌后及腹膜外间隙，从而实现全内脏囊分离（TVS）技术理念。TVS并非单项技术，而是不同的腹壁疝手术中具体执行的技术体系。针对不同类型腹壁疝手术中使用的手术技术与相关解剖细节，本文作了详细论述。同时，重点归纳TVS理念的核心精髓，有助于疝外科同仁更好地实践TVS技术。

关键词: 疝, 腹壁疝, 内镜/腹腔镜, 全内脏囊分离, 肌后修补/腹膜外修补, 补片

Abstract:

The abdominal wall can be treated as a whole physiological and functional entity which is composed of multiple anatomical structures and planes. Surgical approaches and technical details that required for hernic repair are diverse in different area. Indeed, the abdominal wall is confined by several anatomical boundaries which make these surgical planes separated. If one could dissect these boundaries, then separated spaces could be connected, establishing an ample retromuscular/preperitoneal space to accommodate the mesh of ventral hernia repair. The concept of totally visceral sac separation (TVS) is achieved. The TVS concept is not just an isolated technique, but the summary of diverse ventral hernia repair techniques. The article reviewed the relevant anatomy as well as surgical details used in different types of ventral hernia. Meanwhile, the article highlighted the core essence of the TVS concept, in order to facilitate better implementation of TVS techniques by hernia colleagues.

Key words: Hernia, Ventral hernias, Endoscopy/laparoscopy, Totally visceral sac separation(TVS), Retromuscular/ preperitoneal repair, Mesh

中图分类号:

李炳根. 腹腔镜全内脏囊分离技术体系——治疗腹壁疝的微创新理念[J]. 外科理论与实践, 2026, 31(01): 23-31.

LI Binggen. Endoscopic totally visceral sac separation for ventral hernias repair: a novel concept and its technical considera-tions[J]. Journal of Surgery Concepts & Practice, 2026, 31(01): 23-31.

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