Morgagni孔ヘルニアに対して単孔式腹腔鏡下修復術を施行した1例

Single-incision laparoscopic Morgagni hernia repair

◆要旨：患者は56歳の女性．人間ドックの胸部X線検査にて異常陰影を指摘され，胸腹部CT検査にてMorgagniヘルニアを指摘された．大網をヘルニア内容とするMorgagni孔ヘルニアの診断にて単孔式腹腔鏡下修復術を行った．臍からSILSポート^®を挿入した．胸骨背面にヘルニア門を認め，ヘルニア内容の大網は容易に腹腔内に還納が可能であった．ヘルニア門にComposix Mesh^®を固定して手術を終了した．術後経過は良好で第7病日に退院，現在再発は認めていない．Morgagni孔ヘルニアに対する単孔式腹腔鏡下手術を経験したので，若干の文献的考察を加えて報告する．

　The patient was a 56-year-old woman who underwent a comprehensive medical checkup. Because an abnormal shadow was detected on her chest x-ray during the checkup, she was referred to our hospital for further investigation. Computed tomography of the chest and abdomen revealed a hernia of Morgagni. Single-incision laparoscopic repair was performed under the diagnosis of Morgagni's hernia containing the greater omentum. An SILS Port^® was inserted from the umbilicus. The hernia orifice was located behind the sternum. The greater omentum, the content of the hernia, was easily reduced into the abdominal cavity. Composix Mesh^® was fixed over the hernia orifice before the surgery was completed. The postoperative course was uneventful and the patient was discharged on day 7 of hospitalization. Until the present, there has been no evidence of recurrence. We report our experience with single-incision laparoscopic repair for Morgagni's hernia with literature review.