“领带技术”在腹腔镜食管裂孔疝修补及胃底折叠手术中的应用

Application of the "necktie technique" in laparoscopic esophageal hiatal hernia repair and fundoplication surgery

摘要:

随着食管裂孔疝与胃食管反流病发病率持续上升，手术治疗技术亟待优化以改善患者预后。陈双教授团队基于“解剖优先”理念，构建了腹腔镜七步法标准化手术体系，聚焦“神圣平面”精准分离、膈肌脚三维重建及胃底折叠张力控制三大关键环节。针对术中视野受限、操作重复性差等问题，进一步创新提出“领带牵引技术”，借助红色导尿管构建动态牵拉系统，实现术中视野导向、食管轴向复位与胃底折叠量化控制的同步优化。该技术结合生物力学原理，建立了可视化、标准化操作路径，提升了手术的安全性、有效性与可重复性。作为一种融合了解剖修复与抗反流功能重建的创新方案，“领带技术”有望为腹腔镜抗反流手术的规范化推广提供强有力的技术支撑。

Abstract:

With the rising incidence of hiatal hernia and gastroesophageal reflux disease, surgical techniques urgently require refinement to improve patient outcomes. Guided by the concept of "anatomical priority", Professor Chen Shuang's team has established a standardized seven-step laparoscopic protocol, emphasizing three key components: precise dissection of the "sacred plane", three-dimensional crural reconstruction, and tension-controlled fundoplication. To address limitations such as restricted intraoperative visualization and poor reproducibility, the team further developed the innovative "necktie traction technique". This method employs a red pediatric catheter to create a dynamic traction system, enabling directional field exposure, axial esophageal repositioning, and quantitative control of fundoplication. Integrating biomechanical principles, the technique provides a visualized and standardized operative pathway, significantly enhancing surgical safety, efficacy, and reproducibility. As a novel approach combining anatomical restoration with functional anti-reflux reconstruction, the "necktie technique" offers robust technical support for the standardized promotion of laparoscopic anti-reflux surgery.