探讨体内W型悬吊肝左叶在腹腔镜食管裂孔疝修补术中的应用。

回顾性分析2021年1至10月于首都医科大学附属北京友谊医院通州院区普外分中心行腹腔镜食管裂孔疝修补术的13例患者病例资料及手术录像。观察悬吊所用时间及有无悬吊相关并发症（如肝脏撕裂、出血、肝包膜血肿、术后肝功能异常、胆漏）。

13例均顺利完成腹腔镜食管裂孔疝修补术。术中裂孔缝合修补后均采用补片加强固定。行Dor胃底折叠术7例、行Nissen胃底折叠术1例、行Toupet胃底折叠术3例，仅行单纯裂孔修补2例。所有行食管裂孔疝相关手术的患者均顺利完成肝左叶W型悬吊，用时（3.00±1.25）min，术中未借助特殊器械和药物。通过观察手术录像发现有2例出现壁腹膜穿刺点出血，经电钩止血后无明显再出，所有手术患者均未发现有悬吊并发症发生。

在腹腔镜食管裂孔疝修补术中采用体内W型悬吊肝左叶，是一种操作简单、安全、有效的肝悬吊法。

To investigate the application value of the left lobe of the liver in vivo W-shaped suspended in laparoscopic hiatus hernia repair.

A retrospective analysis was performed on laparoscopic hiatal hernia repair data and surgical video of 13 patients from January to October 2021 in Beijing friendship hospital affiliated to the capital university of medical sciences, tong-zhou branch. The suspension time used, and presence of suspension related complications (such as liver torn and bleeding, liver capsular hematoma, postoperative liver dysfunction, bile leakage) were observed.

Laparoscopic hiatal hernia repair was successfully performed in 13 cases. Intraoperative hiatus suture and repair were strengthened with mesh fixation. Dor fundus folding was performed in 7 cases, Nissen fundus folding was performed in 1 case, Toupet fundus folding was performed in 3 cases, and simple hiatus repair was performed in 2 cases. All patients who underwent hiatal hernia-related surgery successfully completed the w-shaped suspension of the left lobe of the liver with a duration of (3.00±1.25) minutes, without special instruments or drugs during surgery. Through surgical video observation, it was found that 2 cases had bleeding at the parietal peritoneal puncture site, and there was no obvious bleeding after hemostasis by electric hook. No suspension complication was found in all patients.

It is a simple, safe and effective method to use the in vivo W-shaped left lobe of liver suspension in laparoscopic hiatal hernia repair.