A case of external supravesical hernia treated by transabdominal preperitoneal repair Kenri AKAMINE 1 , Jun KADONO 1 , Yuki NAGATA 1 , Daisaku KAMIIMABEPPU 1 , Teruhiko WATANABE 1 , Masahiko OSAKO 1 1Department of Surgery, Kagoshima Medical Association Hospital Keyword: 外膀胱上窩ヘルニア , 腹腔鏡 , 術前診断 pp.358-364
Published Date 2019/7/15
DOI https://doi.org/10.11477/mf.4426200723
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 Supravesical hernia is a rare entity and the standard surgical procedure has not been established yet. Furthermore, it is difficult to make a preoperative diagnosis. Likewise, supravesical hernia comprised of a sliding urinary bladder that is treated by transabdominal preperitoneal repair (TAPP) is also rare. We herein report a case of preoperatively diagnosed supravesical hernia treated by TAPP. A 73-year-old man with right inguinal bulging accompanied by pain was referred to our hospital with the provisional diagnosis of direct inguinal hernia. Since the hernia itself could be palpated more medially compared to the external inguinal ring, the hernia was diagnosed as supravesical hernia. Laparoscopic TAPP was chosen to obtain a view of the hernia site. Laparoscopic views clearly revealed the porta hernia located just close to the pubic nodule and the right wall of the urinary bladder sliding into it. After pulling out the adhered urinary bladder and dissecting the preperitoneal space, the porta hernia was widely covered by mesh. Laparoscopic procedure for supravesical hernia was useful because we were able to safely dissect the peritoneal space wide enough to cover the subpubic nodule without bladder injury.

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