Morgagni孔ヘルニアに対するComposixTM Meshを用いた腹腔鏡下修復術の1例

Laparoscopic repair of Morgagni hernia with a ComposixTM Mesh

　Morgagni孔ヘルニアに対しComposix^TM Meshを用いた腹腔鏡下修復術を行った．症例は58歳，女性．健診時の胸部X線写真で発見され，MRIにて大網を内容とするMorgagni孔ヘルニアと診断された．手術はトロッカーを4本使用し，低圧気腹下での腹腔鏡手術で行った．大網は容易に腹腔内に還納し得た．ヘルニア嚢は切除せず，ヘルニア門を直接縫合・閉鎖し，さらに縫合部にComposix^TM Meshを追加固定して補強した．Morgagni孔ヘルニアの手術法として，低侵襲，早期離床，早期退院などの利点が得られる内視鏡下修復術が適しており，Composix^TM Meshを用いることでヘルニア嚢を切除せずに容易かつ確実な手術が可能と考える．

We present a case who underwent laparoscopic repair of Morgagni hernia with a Composix^TM Mesh. A 58 year -old woman was diagnosed as a Morgagni hernia including the greater omentum, by chest X-ray and MRI. Laparoscopic repair was performed. At first, 4 trocars were inserted into her abdomen, and CO₂₎ insufflated to an intraabdominal pressure of 6~8 mmHg. The herniation was easily reduced, but the hernial sac was left in place without resection. The hernial hilum was closed by suturing, and furthermore a Composix^TM Mesh was sta-pled over the sutures.