A Case of Recurrent Extraperitoneal Inguinal Bladder Hernia Using a Totally Extraperitoneal Approach (TEP)
نویسندگان
چکیده
症例は52歳，男性．右鼠径ヘルニアに対して10年前にメッシュ修復術による手術歴があり，2週間前からの右鼠径部違和感を主訴に受診した．初診時，右鼠径部に臥位で容易に還納されるうずら卵大の膨隆を認めた．鼠径部除圧下腹臥位CTで下腹壁動静脈の内側より脱出する膀胱を認め，右鼠径部膀胱ヘルニアと診断した．再発症例のためTAPP（transabdominal preperitoneal approach）法を予定したが腹腔内にヘルニア門を同定できず，腹膜外型膀胱ヘルニアと術中診断し，速やかにTEP（totally extraperitoneal approach）法へ変更した．約1cmのヘルニア門を同定し，マージンを確保するようにメッシュを形成して留置し再発なく経過している．腹膜外型膀胱ヘルニアに対するTEP法はヘルニア門の同定が容易であり，膀胱損傷回避の観点からもより有用と考えられ報告する．
منابع مشابه
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ژورنال
عنوان ژورنال: Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)
سال: 2022
ISSN: ['1345-2843', '1882-5133']
DOI: https://doi.org/10.3919/jjsa.83.1539