腹腔鏡下に修復した白線ヘルニアの1例

A patient with laparoscopic linea alba hernia repair

◆要旨：白線ヘルニアは腹壁正中線に発生するヘルニアで，白線を通じて腹膜に包まれた腹腔内臓器が脱出するヘルニアであり，わが国では比較的稀な疾患である．今回，筆者らは白線ヘルニアに対して腹腔鏡下に修復した1例を経験したので報告する．患者は65歳，男性．上腹部正中に膨隆と痛みを認め，腹部CT検査で白線ヘルニアと診断した．手術は腹腔鏡下にヘルニア門をComposix Kugel Patch^Ⓡで固定した．腹腔鏡下でのヘルニア修復術は，へルニア門の部分に皮膚切開を置かないため，創部感染に続発するメッシュ感染も少なく，皮膚切開も小さいことから術後疼痛の少ない有用な術式と考えられる．

　Linea alba hernia is the condition that occurs on the midline of abdomen when intraabdominal organs, which are covered with peritoneum, protrude through linea alba. It is comparatively a rare condition in Japan. In this study, we report a patient with linea alba hernia who was treated laparoscopically.

A 65-year-old man visited our hospital because of a swelling on the midline of the upper abdomen. Diagnosis with CT examination confirmed it to be linea alba hernia. Surgical operation was performed laparoscopically. Composix Kugel Patch^Ⓡwas inserted into abdomen and fixed on the abdominal wall. As laparoscopic hernia repair place no incision adjacent to hernia orifice, there is fewer incidence of mesh infection secondary to wound infection. Small skin incisions also contribute to less pain to the patients. Therefore, laparoscopic hernia repair is a feasible procedure.