腹腔鏡下にbarbed sutureを用いて修復したMorgagni孔ヘルニアの1例

A case of Morgagni hernia repaired laparoscopically with barbed suture

◆要旨：Morgagni孔ヘルニアは胸骨後部に発生する稀な横隔膜ヘルニアである．今回，大網がMorgagni孔ヘルニアに嵌入し胸部不快感を呈した症例に腹腔鏡下でbarbed sutureを用いて縫合閉鎖し，良好な成績を得た．症例は91歳，女性．胸の苦しさを主訴に受診した．CTでMorgagni孔ヘルニアへ大網の嵌入を認めた．胸部不快感の原因と診断し手術を行った．腹腔鏡下に大網を引き出しヘルニア囊を切除後，2-0 barbed sutureで2重に縫合閉鎖した．術後7日目に退院，術後1年7か月，再発を認めていない．barbed sutureによる腹腔鏡下修復術は低侵襲で簡便であるため，有用である可能性がある．

　Morgagni hernia is a rare diaphragmatic hernia that rising from posterior part of the sternum. We have performed laparosopic repair of Morgagni hernia with barbed suture successfully. The patient was a 91-year-old woman with a complaint of chest discomfort. Computed tomography revealed her symptom was caused by the omentum inserted into Morgagni hernia and a laparoscopic repair was performed. After the omentum was repositioned and the hernia sac was resected, the orifice was closed doubly by a 2-0 barbed suture. The postoperative course was uneventful, and has not had any recurrence for one year and seven months. The laparoscopic repair of Morgagni hernia using barbed suture is a useful technique because it is minimally invasive and simple.