超音波ガイド下に非観血的整復を行い，待機的に腹腔鏡下修復術を施行した閉鎖孔ヘルニアの1例

A Case of Elective Laparoscopic Hernia Repair for an Obturator Hernia Following Manual Reduction under Ultrasonography

　患者は71歳，女性．右下腹部，鼠径部痛で受診した．超音波検査で右閉鎖孔ヘルニアと診断し，超音波ガイド下に徒手整復を施行したところ，症状は劇的に改善した．待機的に腹腔鏡下にヘルニア門の閉鎖とポリプロピレンメッシュによる補強を行った．術後第10病日目で退院し，その後，約1年間，再発を認めていない．閉鎖孔ヘルニアに対する超音波ガイドによる整復は発症早期には施行する価値のある手技であり，また，腹腔鏡下修復術は低侵襲で，かつ有用な術式である．

A 71-year old woman was seen at the hospital because of the right lower abdominal and the right inguinal pain. The diagnosis of right obturator hernia was made by the ultrasonography (USG). Manual reduction under USG resulted in dramatic improvement of the symptom. We underwent laparoscopic operation, and a polypro-pylene mesh was used to repair the hernia. She was discharged 10 days after the surgery. There has been no physical sign of recurrence, a year after surgery. Manual reduction under USG is a valuable technique in early state, and laparoscopic surgery is minimally invasive and is a reliable treatment for this hernia.