腎移植後患者に腹腔鏡下鼠径ヘルニア手術を施行した2例

Two cases of trans-abdominal preperitoneal repair for renal transplant patients with inguinal hernia

◆要旨：腎移植後，移植側の鼠径ヘルニアに対して腹腔鏡下鼠径ヘルニア手術を施行した2例を経験した．症例1は54歳，男性．24歳時に右腸骨窩に腎移植を受けた後に廃絶し，43歳時に左腸骨窩に腎移植を施行された．右鼠径部腫脹を認め，右鼠径ヘルニアと診断し腹腔鏡下鼠径ヘルニア手術を施行した．症例2は43歳，男性．25歳時に右腸骨窩に腎移植を施行された．右鼠径部腫脹を認め，右鼠径ヘルニアと診断し腹腔鏡下鼠径ヘルニア手術を施行した．いずれの症例も，移植腎や尿管の損傷なく安全に手術することができた．腹腔鏡下鼠径ヘルニア手術は腎移植後鼠径ヘルニア修復において有用な術式の1つであると考えられた．

　We report two cases of laparoscopic inguinal hernia surgery （trans-abdominal preperitoneal approach : TAPP） for renal transplant patients. Case1 is a 54-year-old man who underwent kidney transplant at the age of 24 and 43 due to renal failure from the age of 15. He complained of swelling of the right groin and visited our hospital. The patient was diagnosed as having right inguinal hernia and underwent TAPP. Case 2 is a 43-year-old man who underwent kidney transplant at the age of 25 due to renal failure from IgA nephropathy. He complained of swelling of the right groin and the diagnosis was right inguinal hernia. The patient underwent TAPP. In both cases, we were able to perform the operations safely without damaging the transplanted kidney and ureter. TAPP can be performed for an inguinal hernia after renal transplant.