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中华胃食管反流病电子杂志

中华胃食管反流病电子杂志 ›› 2023, Vol. 10 ›› Issue (03) : 117 -120. doi: 10.3877/cma.j.issn.2095-8765.2023.03.001

专家共识

成人机器人辅助食管裂孔疝修补抗反流手术中国专家共识（2023版）
中国医师协会外科医师分会胃食管反流病专业学组, 新疆维吾尔自治区普外微创研究所, 新疆胃食管反流病与减重代谢外科临床医学研究中心   
  • 收稿日期:2023-07-13 出版日期:2023-08-15
  • 基金资助:
    新疆维吾尔自治区重点研发任务专项-厅厅联动项目“胃食管反流病与肥胖相关代谢性疾病多学科诊疗体系构建关键技术研究与应用”(2023B03010); 军委后勤保障部卫生局技术标准项目“老年保健对象食管裂孔疝微创治疗的研究”(21BJZ14)

Chinese expert consensus on adult robot assisted esophageal hiatal hernia repair and anti reflux surgery (2023 )

Gastroesophageal Reflux Disease Professional Committee of the Surgical Branch of the Chinese Medical Association, Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery   

  • Received:2023-07-13 Published:2023-08-15
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中国医师协会外科医师分会胃食管反流病专业学组, 新疆维吾尔自治区普外微创研究所, 新疆胃食管反流病与减重代谢外科临床医学研究中心. 成人机器人辅助食管裂孔疝修补抗反流手术中国专家共识（2023版）[J]. 中华胃食管反流病电子杂志, 2023, 10(03): 117-120.

Gastroesophageal Reflux Disease Professional Committee of the Surgical Branch of the Chinese Medical Association, Research Institute of General and Minimally Invasive Surgery, Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery. Chinese expert consensus on adult robot assisted esophageal hiatal hernia repair and anti reflux surgery (2023 )[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2023, 10(03): 117-120.

食管裂孔疝(HH)是胃食管连接部和胃通过膈肌的食管裂孔进入纵隔，多数HH患者伴有胃食管反流病。机器人HH修补术是HH微创外科发展的重要趋势，近年来机器人HH修补术取得快速发展。但是目前没有明确共识用于临床工作中，为了规范HH的机器人手术治疗，由中国医师协会外科医师分会胃食管反流病专业委员会牵头，邀请国内相关领域专家对国内外有关文献进行检索、讨论，并召开了多次专家研讨会，制订了本专家共识，以期为进一步促进我国机器人HH手术的开展提供指导与参考。

关键词: 食管裂孔疝, 胃食管反流病, 微创外科, 达芬奇机器人手术系统

Hiatus hernia (HH) is the entry of the abdominal component of the gastroesophageal junction and stomach into the mediastinum through the esophageal hiatus in the diaphragm, and most patients with hiatus hernia have gastroesophageal reflux disease (GERD). Robotic esophageal hiatal hernia repair is an important trend in the development of minimally invasive surgery for esophageal hiatal hernia, and robotic esophageal hiatal hernia repair has achieved rapid development in recent years. However, there is no clear guideline used in clinical work. In order to standardize the robotic surgical treatment of esophageal hiatal hernia, the Specialized Committee on GERD of the Chinese Physicians' Association of Mountain and Abdominal Wall Surgeons Branch took the lead, invited domestic experts in related fields to search and discuss the relevant literature at home and abroad, and held several expert seminars to develop this expert consensus. The "Chinese Expert Consensus on Robotic Esophageal Hiatal Hernia Surgery (2022 Edition)" was formed to provide guidance and reference for further promoting robotic esophageal hiatal hernia surgery in China.

Key words: Hiatus hernia, Gastroesophageal reflux disease, Minimally invasive surgery, daVinci robotic surgical system
图1 机器人常见套管体表示意图
图2 机器人 辅助食管裂孔疝修补术术中关键步骤　图2a　用超声刀切开小网膜；离断膈食管韧带，膈胃韧带后可以看到肝尾状叶和食管裂孔；图2b　保留迷走神经肝胆支，完全游离疝囊及疝环；缝合关闭疝环；图2c　选择合适补片修剪后固定；并行胃底折叠术；折叠瓣在左右侧膈肌脚缝合U形固定1～2针
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