A case in which laparoscopic surgery was useful for re-repairing of right superior lumbar hernia Kengo KAI 1 , Koichiro SANO 1 , Takahiro OCHIAI 1 , Shuichiro UCHIYAMA 1 , Hideto SUETA 1 , Atsushi NANASHIMA 2 1Department of Surgery, Miyakonojo Medical Association Hospital 2Department of Surgery, University of Miyazaki Faculty of Medicine Keyword: 上腰ヘルニア , 腹腔鏡下手術 , 再手術 pp.10-15
Published Date 2020/1/15
DOI https://doi.org/10.11477/mf.4426200765
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 A 75-year-old man was admitted to hospital with a palpable soft mass in the right lumbar area. Computed tomography and magnetic resonance imaging (MRI) revealed a superior lumbar hernia. The lumbar hernia was repaired using a BARD direct Kugel patch® for the defected aponeurosis of the transversus abdominis muscle. Two weeks after the operation, a dorsal palpable mass and MRI revealed that the lumbar hernia had been incompletely treated. Five months after the first surgery, laparoscopic surgery using an intra-abdominal approach was performed for the purpose of identifying the hernia orifice correctly, different from the initially treated site. Consequently, it was assessed that we misunderstood the aponeurosis injured in the process of separating the abdominal wall as the hernia orifice, on which the mesh was placed in primary operation. The postoperative course was uneventful, and the patient was discharged 7 days after surgery. There was no sign of recurrence for 15 months after the secondary operation. Laparoscopic surgery for lumbar hernia was found to be appropriate to address the hernia orifice.

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