ラパヘルクロージャー®を用いて単孔式腹腔鏡下に修復した乳幼児Morgagni-Larrey孔ヘルニアの1例

Morgagni-Larrey hernia repaired by single-incision laparoscopy with a Lapa-Her-Closure® needle : A case report

◆要旨：患児は1歳7か月の男児で，心房中隔欠損症にて当院小児循環器科通院中であった．胸部造影CT検査にてMorgagni-Larrey孔ヘルニアと診断された．内径5mmのEZトロッカー3本を刺入したEZアクセスミニタイプ^®（八光）を臍に装着し，単孔式腹腔鏡下に修復術を行った．ラパヘルクロージャー^®（八光，以下LPEC針）を補助的に用いて非吸収糸による水平マットレス縫合4針と結節縫合3針にてヘルニア門を直接閉鎖した．術後3日目に退院となり，以後再発を認めていない．Morgagni-Larrey孔ヘルニアに対する単孔式腹腔鏡下修復術は，LPEC針を用いることで簡便で確実に施行可能であり，低侵襲かつ整容性に優れた術式と考えられた.

　We report our experience of a single-port laparoscopic repair using a suturing needle device to treat an infant with Morgagni-Larrey hernia. A one-year-old boy who had an arterial septal defect was diagnosed with asymptomatic Morgagni-Larrey hernia via contrast-enhanced chest computed tomography. Three 5-mm EZ Trocars^® were inserted through an EZ Access^® placed at the umbilicus with a single-incision, and the diaphragmatic defect was directly closed with four horizontal mattress sutures and three interrupted sutures using a Lapa-her-closure^® needle. The patient was discharged three days postoperatively, without any complications or recurrences. This minimally invasive single-incision laparoscopic repair for Morgagni-Larrey hernia using a special needle is a simple and reliable procedure that also provides cosmetic advantages.