腹腔鏡下に修復した高齢者白線ヘルニアの1例

Laparoscopic repair of linea alba hernia in an elderly woman

◆要旨：腹腔鏡下に修復した高齢者白線ヘルニアの1例を経験したので報告する．患者は81歳，女性．臍上部の疼痛を主訴に来院した．臍上部正中に手拳大の腫瘤を触知し，腹部CT検査にて筋膜欠損部と脂肪組織の脱出を認めた．白線ヘルニアの診断にて腹腔鏡下修復術を施行した．腹腔鏡下に観察すると臍の約1cm頭側に長径15mm大のヘルニア門を認め白線ヘルニアと診断した．150×100mmのComposix Mesh^Ⓡを腹腔内より固定し，ヘルニア修復術を施行した．術後8日目に軽快，退院した．現在まで再発の徴候はない．白線ヘルニアに対する腹腔鏡下修復術は安全かつ有用な術式と考えられたため，若干の文献的考察を加えて報告する．

　We report a patient with linea alba hernia, treated by laparoscopic surgery. The patient was an 81-year-old woman with epigastric pain. A fist-size mass was palpated at superior area of the umbilicus. Abdominal computed tomography revealed a defect of the linea alba and a protrusion of fat tissue in the subcutaneous layer. A diagnosis of linea alba hernia was made, and laparoscopic operation was performed. Under the laparoscopic view, defect of the fascia which measured 15 mm in diameter was recognized at the superior area of the umbilicus. Laparoscopic repair was performed by using 150 mm×100 mm Composix Mesh^Ⓡ. The patient was discharged from the hospital on the 8 th postoperative day. There have been no signs of recurrence up to now.

　Linea alba hernia is relatively rare in Japan, and there have been few reports of patients who were treated by laparoscopic surgery. Laparoscopic repair can be adopted for the treatment of linea alba hernia in an adult because of its feasibility and safety.