【摘要】 胃底折叠术的发展进程，始终以解剖学认知的持续深化与外科技术的迭代革新为双轮驱动，而膜解剖理论的引入，更为该术式的规范化开展提供了理论支撑。术中对食管下段及胃底的精准游离、胃短血管的精细化处理，以及基于病人个体食管功能状态的术式选择，是保障手术疗效、降低吞咽困难等术后并发症发生率的核心要点。此外，机器人手术系统凭借三维视野清晰、操作灵活精准的独特优势，显著优化了食管裂孔疝修补联合胃底折叠术中膈肌脚缝合、补片固定及胃底折叠的操作流程；各类改良胃底折叠术则通过创新固定策略，在巩固抗反流屏障的同时，为降低术后疝复发风险开辟了颇具潜力的研究方向。更多还原

【Abstract】 The development of fundoplication has been driven by two intertwined forces: the continuous deepening of anatomical understanding and the iterative advancement of surgical techniques. The introduction of membrane anatomy theory has further provided theoretical support for the standardization of this procedure. Key factors ensuring surgical efficacy and reducing postoperative complications such as dysphagia include precise dissection of the distal esophagus and gastric fundus, meticulous management of the short gastric vessels, and selection of the surgical approach based on the patient’s individual esophageal function. Furthermore, the robotic surgical system, with its unique advantages of clear three-dimensional vision and flexible, precise manipulation, has significantly improved the performance of crural closure and mesh fixation during hiatal hernia repair. Meanwhile, various modified fundoplication techniques, through innovative fixation strategies, not only reinforce the anti-reflux barrier but also open promising avenues for reducing the risk of postoperative hernia recurrence.更多还原