腹壁外科技术的发展趋势与材料学进展
Development trends and material advances in abdominal wall surgery
-
摘要: 腹壁外科的技术发展历程,是一部从传统组织缝合到补片加强修复的演进史。纵观其发展历程,从开放手术的无张力修补,到腹腔镜技术的引入,再到以增强视野全腹膜外修补术为代表的肌后修补新理念,清晰地展现了外科医师对腹壁解剖与生物力学认知的深化过程,其技术演进的逻辑已从单纯的解剖修复转向功能重建与层次复位。与此同时,材料学的突破为这一进程提供了支持:从早期不可吸收合成补片的惰性支架修补理念,到可吸收材料的再生修复设计,再到当前以仿生修饰、免疫调控及三维打印智能支架为代表的功能化材料发展,未来修补材料将沿着“精准适配‑动态适应‑功能整合‑个体定制”的轨迹持续演进,最终实现从替代修复向再生重建的根本性跨越。笔者结合团队临床经验和文献学习,回顾腹壁外科的手术方式和修补材料发展变化,重点梳理修补理念以及材料未来发展的新趋势,以期为临床实践提供参考。Abstract: The technological development of abdominal wall surgery represents an evolu-tionary history from traditional tissue suture to mesh‑reinforced repair. Examining its trajectory⁃from tension‑free repair in open surgery to the introduction of laparoscopic techniques, and further to the novel concept of retromuscular repair exemplified by enhanced‑view totally extraperitoneal repair-clearly demonstrates the deepening understanding of abdominal wall anatomy and biomech-anics among surgeons. The underlying logic of this technological evolution has shifted from mere "anatomical repair" towards "functional reconstruction" and "restoration of anatomical planes". Concurrently, breakthroughs in materials science have provided critical support for this progression: from the early concept of "inert scaffold" repair with non‑absorbable synthetic meshes, to the "regenerative repair" design of absorbable materials, and further to the current development of functional materials represented by biomimetic modification, immunomodulation, and three-dimen-sional-printed intelligent scaffolds. Future repair materials will continue to evolve along the trajectory of precise adaptation, dynamic responsiveness, functional integration, and individualized customization, ultimately achieving a fundamental leap from replacement repair to regenerative reconstruction. Based on clinical experience and a review of the literature, the authors summarize the evolution of surgical procedures and repair materials in the field of abdominal wall surgery, with a focus on evolving repair concepts and emerging trends in future material development, in the hope of provi-ding a useful reference for colleagues.

下载: