单孔腹腔镜腹股沟疝修补术要点解析与技巧优化OA

Single incision laparoscopic transabdominal preperitoneal(TAPP)repair for inguinal hernia has become a focus in minimally invasive hernia surgery due to its scar-free cosmetic advantage.However,the inherent axial vision in single incision laparoscopy leads to operative difficulties such as the"chopstick effect"and visual compression,which constitute the bottleneck for the popularization of this technique.It is recommended to adopt a single-incision trocar placement via the transumbilical"hare-lip"incision combined with the umbilical fascia plane.By adopting the strategy of"replacing lateral distance with the anteroposterior movement of bilateral instruments"during the operation,combined with adjustments of the angle and position of the laparoscopic lens,the operational difficulties caused by the"chopstick effect"are resolved.The Cartesian coordinate system can be adopted to clarify the separated angular relationship between the lens and the instruments(i.e.,the"unipolar operating view").The core technique of one-handed peritoneal suturing is precise control of the needle,ensuring that it always remains engaged in the peritoneum without leaving the field of view,thereby allowing the coordinated actions of grasping and releasing to be performed smoothly for efficient suture closure.