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Epigastric hernia repaired using the transabdominal preperitoneal approach Yasuaki OIRI 1 , Naoya YAMAGUCHI 1 , Yuichiro KATO 1 , Toshiki MUKAI 1 , Fumiya FUKUI 1 , Shinji KATO 1 1Department of Surgery, Nagoya Ekisaikai Hospital Keyword: 白線ヘルニア , 腹腔鏡下手術 , transabdominal preperitoneal approach pp.224-230
Published Date 2020/5/15
DOI https://doi.org/10.11477/mf.4426200805
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 A 68-year-old man presented with subcutaneous epigastric swelling, which had been present for 4 years, but recently became mildly painful. Abdominal computed tomography showed a defect in the linea alba in the midline of the upper abdomen and protrusion of fat tissue into the subcutaneous layer. We diagnosed the patient with epigastric hernia, which was reducible; hence, we performed elective laparoscopic surgery. In the beginning of the laparoscopic operation, neither the hernia orifice nor the hernia sac could be found. However, after dissecting the preperitoneal cavity in the upper abdomen, we could detect the hernia orifice in the linea alba with protrusion of the preperitoneal fat of the round ligament of the liver. Hernia repair was performed with placement of a mesh using the transabdominal preperitoneal (TAPP) technique. The postoperative course was uneventful, and no signs of recurrence of hernia or chronic pain were detected for 1 year. Mesh repair with TAPP technique would be useful in patients with epigastric hernia, especially those in whom the hernia orifice or sac could not be found on laparoscopy.


Copyright © 2020, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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