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中华胃食管反流病电子杂志 ›› 2025, Vol. 12 ›› Issue (04) : 165 -168. doi: 10.3877/cma.j.issn.2095-8765.2025.04.007

综述

从腹腔镜到机器人:食管裂孔疝修补术的技术演进、争议与展望
刘忠杰1,2,3,4, 吴瑜2,3,4,5,()   
  1. 1300070 天津医科大学研究生院
    2300000 天津医科大学南开医院
    3300000 天津市急腹症器官损伤与中西医修复重点实验室
    4300000 天津市急腹症研究所
    5300000 天津医科大学附属南开医院胃肠外科
  • 收稿日期:2025-09-18 出版日期:2025-11-15
  • 通信作者: 吴瑜

From laparoscopy to robotics: technological evolution, controversies, and prospects in hiatal hernia repair

Zhongjie Liu1,2,3,4, Yu Wu2,3,4,5,()   

  1. 1Graduate School of Tianjin Medical University, Tianjin 300070, China
    2Tianjin Medical University Nankai Hospital, Tianjin 300000, China
    3Tianjin Key Laboratory of Acute Abdominal Disease-Associated Organ Injury and Integrated Traditional Chinese and Western Medicine Repair, Tianjin 300000, China
    4Tianjin Institute of Acute Abdominal Diseases, Tianjin 300000, China
    5Department of Gastrointestinal Surgery, Nankai Hospital Affiliated to Tianjin Medical University, Tianjin 300000, China
  • Received:2025-09-18 Published:2025-11-15
  • Corresponding author: Yu Wu
引用本文:

刘忠杰, 吴瑜. 从腹腔镜到机器人:食管裂孔疝修补术的技术演进、争议与展望[J/OL]. 中华胃食管反流病电子杂志, 2025, 12(04): 165-168.

Zhongjie Liu, Yu Wu. From laparoscopy to robotics: technological evolution, controversies, and prospects in hiatal hernia repair[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2025, 12(04): 165-168.

食管裂孔疝的外科治疗经历了从开胸、开腹、胸腔镜到腹腔镜、机器人的微创革命。近年来,腹腔镜手术已成为腹部外科手术的金标准术式。而机器人手术系统的引入标志着新一轮的技术演进。本文主要回顾食管裂孔疝修补术从腹腔镜手术到机器人手术的技术发展历程,重点对比2种微创技术在手术精度、学习曲线、围手术期结局及成本效益方面的证据。同时,深入探讨当前存在的核心争议,如补片应用、胃底折叠术式选择等,并展望包括人工智能、技术提升在内的未来技术发展方向。本文认为,机器人手术平台具有显著的技术优势,可为食管裂孔疝修补提供技术支持,但其广泛应用仍需更高级别的循证医学证据。

The surgical treatment of hiatal hernia has undergone a minimally invasive revolution, progressing from open thoracotomy and laparotomy to thoracoscopy, laparoscopy, and robotics. In recent years, laparoscopic surgery has become the gold standard in abdominal surgery. The introduction of robotic surgical systems signifies a new wave of technological evolution. This article primarily reviews the technical development of hiatal hernia repair from laparoscopy to robotics, focusing on comparing the evidence regarding surgical precision, learning curve, perioperative outcomes, and cost-effectiveness between these two minimally invasive techniques. It also delves into current core controversies, such as the application of mesh and the choice of fundoplication techniques, and looks ahead to future technological directions including artificial intelligence and technical advancements. This article posits that the robotic surgical platform offers significant technical advantages for hiatal hernia repair, but its widespread application still requires higher-level evidence-based medical support.

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