鼠径ヘルニア術後に発症した外膀胱上窩ヘルニアに対して腹腔鏡下ヘルニア修復術が有用であった2例

Two cases of laparoscopic hernia repair for extravesical supravesical hernia that developed after inguinal hernia surgery

◆要旨：症例1は70歳，男性．3年3か月前に右外鼠径ヘルニアに対してmesh plug法での手術歴あり．右鼠径部の膨隆を主訴に当院を受診した．鼠径ヘルニア再発を疑い腹腔鏡下ヘルニア修復術（以下，TAPP）を施行した．術中所見で右外膀胱上窩ヘルニアと診断した．症例2は57歳，男性．2年9か月前に右外鼠径ヘルニアに対してmesh plug法の手術歴あり．右鼠径部の膨隆を主訴に当院を受診した．鼠径ヘルニア再発を疑いTAPPを施行した．術中所見で右外膀胱上窩ヘルニアと左外鼠径ヘルニアと診断した．腹腔鏡手術は膀胱上窩ヘルニアのような特殊な再発形式に対しても確実な診断と治療に有用であると考えられた．

　Case 1 was a 70-year-old male. He had a history of operation with mesh plug method for right lateral inguinal hernia 3 years and 3 months ago. He visited our hospital with a complaint of swelling in the right inguinal region. We suspected recurrent inguinal hernia and performed transabdominal preperitoneal repair（TAPP）. Intraoperative findings revealed right external supravesical hernia. Case 2 was a 57-year-old male. He had a history of operation with mesh plug method for right lateral inguinal hernia 2 years and 9 months ago. He visited our hospital with a complaint of swelling in the right inguinal region. We suspected recurrent inguinal hernia and performed TAPP. Intraoperative findings revealed right external supravesical hernia and left lateral inguinal hernia. Recurrent inguinal hernias may include a certain number of supravesical hernias, and laparoscopic surgery is considered to be useful for accurate diagnosis and treatment in cases with special recurrence patterns.