Challenges of surgical techniques improvement for abdominal hernia and repair materials development to hernia surgery

Jianxiong Tang
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Abstract

The purpose of hernioplasty is to repair defects and restore abdominal wall function, and ultimately to improve the quality of patients′ life. With the innovation of basic theories, anatomical concepts, surgical techniques and repair materials, hernioplasty has made tremendous progress, but its basic principles of treatment have not changed. In recent 20 years, hernia surgery in China has entered a period of comprehensive and rapid development, showing a leap in the level of diagnosis and treatment, surgical technology, the number of operations and other aspects. Meanwhile, a series of clinical quality control systems, such as training, registration and adverse event monitoring, have been established, making China the top level of the world as a whole. At present, the surgical methods of abdominal wall hernia are flourishing and developing rapidly. The application of different levels, different approaches and different materials in the treatment of individualized patients has shown good clinical results. Of course, there is no repair material that meets the requirements of "ideal patch" . Although the implantation of synthetic materials has greatly improved the clinical effect of hernia, the permanent presence of foreign materials also brings about the possibility of long-term complications. A series of absorbable materials represented by "tissue-induced biomaterials" are closer to human tissues, which may represent the direction of the development of hernia repair materials, but long-term follow-up results are still needed to confirm their clinical efficacy. Key words: Hernia; Abdominal hernia; Surgery; Materialogy
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腹疝手术技术改进的挑战及腹疝手术修复材料的发展
疝修补术的目的是修复腹壁缺损,恢复腹壁功能,最终提高患者的生活质量。随着基础理论、解剖学观念、手术技术和修补材料的创新,疝成形术取得了巨大的进步,但其治疗的基本原则并没有改变。近20年来,中国疝外科进入了全面快速发展的时期,在诊疗水平、手术技术、手术数量等方面都出现了飞跃。同时,建立了培训、注册、不良事件监测等一系列临床质量控制体系,使中国整体处于世界一流水平。目前,腹壁疝的手术治疗方法蓬勃发展。不同层次、不同途径、不同材料在个体化患者治疗中的应用取得了良好的临床效果。当然,没有一种修补材料符合“理想补片”的要求。虽然人工合成材料的植入大大提高了疝的临床疗效,但异物的永久存在也带来了长期并发症的可能。以“组织诱导生物材料”为代表的一系列可吸收材料更接近人体组织,这可能代表了疝修补材料的发展方向,但其临床疗效仍需要长期随访结果来证实。关键词:疝;腹部疝;手术;外延
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中华消化外科杂志
中华消化外科杂志 Medicine-Gastroenterology
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4544
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