膜解剖理论指导食管裂孔疝手术的现状与未来:聚焦腹段食管精准游离OA

The membrane anatomy theory,grounded in the perspective of histoembryonic development,integrates traditional concepts such as"fascia","mesentery","space","plane",and"channel".This theory can be extended to the surgical treatment of hiatal hernia.Improper dissection planes during the mobilization of the abdominal esophagus may damage the diaphragmatic crus fascia and muscle fibers,compromising suture stability,increasing the risk of recurrence,and potentially leading to esophageal wall in-jury,pneumothorax,or vagus nerve damage.Therefore,precise plane control is crucial for surgical success.The mobilization of the abdominal esophagus primarily involves the separation of the left and right diaphragmatic crus spaces and the dissection of the e-sophagus within the mediastinum.Its anatomical structure at the diaphragmatic dome shares similarities with the pelvic rectum,allo-wing the surgical principles of total mesorectal excision to be referenced,aiming to achieve complete mobilization within clear anatomi-cal planes.Surgery guided by membrane anatomy not only ensures anatomical accuracy and improves safety but also contributes to functional preservation.With the deep integration of"cognitive enhancement"brought by artificial intelligence technology and"visual and operational enhancement"provided by robotic surgical systems,hiatal hernia surgery is expected to develop in the direction of being safer,more precise and effective.