腹腔鏡下根治術を行った両側閉鎖孔ヘルニアの1例

A Case of Bilateral Obturator Hernias Repaired by Laparoscopic Surgery

　ヘルニオグラフィー，骨盤CTにて術前確定診断が得られ．腹腔鏡下根治術を行った両側閉鎖孔ヘルニアの1例を経験したので報告する．症例は58歳の女性で，繰り返す腸閉塞症状とHowship—Romberg徴候と考えられる右大腿内側部痛にて入退院を繰り返していた．原因検索のために行ったヘルニオグラフィーで左側のヘルニア嚢を認め，骨盤CTにて両側に閉鎖孔ヘルニアを確認し得た．手術は腹腔鏡下にポリプロピレンメッシュによるヘルニア門の閉鎖，補強を行った．術後は，術前に認めた右大腿内側部痛も消失し，術後1年4か月再発は認められていない．本術式は低侵襲で，確実かつ有用な治療法と考えられた．

We report a case of bilateral obturator hernia which was preoperatively diagnosed by herniography and CT scanning, and thus laparoscopically repaired. A 58-year-old woman repeatedly had intestinal obstruction and a right thigh pain suggestive of Howship-Romberg sign. A left obturator hernia was confirmed by herniography, and bilateral obturator hernias were observed by CT scanning. The patient underwent laparoscopic surgery, and a polypropylene mesh was used to repair the hernias. After surgery, she had no abdominal symptoms and no physical signs of obturator hernia.