腹腔鏡下手術を施行した外傷性腹壁ヘルニアの1例

A case of laparoscopic surgery for a traumatic abdominal wall hernia

◆要旨：患者は41歳，男性．交通事故で当院へ救急搬送され，右側腹部打撲を認めた．その後徐々に打撲部位に膨隆を認め，CTで同部位に腹壁ヘルニアを認めたため，受傷後約11か月目に手術治療を行った．手術は腹腔鏡下にて腹腔内よりヘルニア門を同定するtransabdominal preperitoneal approach（TAPP法）で行い，形状記憶リングを有したメッシュを用いて修復した．第3病日に経過良好で退院となり，現在再発は認めていない．外傷性腹壁ヘルニアに対する腹腔鏡下手術の報告例は少なく，今回筆者らは腹腔鏡下腹壁ヘルニア修復術を施行し，安全かつ有用であった1例を経験したので報告する．

　A 41-year-old man had been involved in a traffic accident. Emergency survey was carried out, and he went home as right abdominal quadrant contusion at the first medical examination. Several months later, he noticed a bulge in his right flank, and it was diagnosed as a traumatic wall hernia by a computed tomography. A laparoscopic TAPP repair was performed for this hernia. We used BARD VENTRIO mesh^TM. This repair was done 11 months after the traffic accident. The postoperative course was uneventful, and the patient was discharged from our hospital on the post-operative day 3. There have been no signs of recurrence. Thus, a laparoscopic repair was useful for the treatment of a traumatic wall hernia.