腹腔鏡下にTAPP法を施行した白線ヘルニアの2例

Two cases of linea alba hernia treated by laparoscopic transabdominal preperitoneal technique

◆要旨：症例1は70歳，男性．半年前より上腹部膨隆が出現し当科受診となった．上腹部正中に直径3cmのヘルニア門を認め，CT検査にて白線ヘルニアと診断した．症例2は51歳，男性．20年前より上腹部に膨隆を自覚していたが徐々に増大し，疼痛と熱感を伴うようになった．また両側鼠径部に膨隆も出現したため当科受診となった．上腹部正中に直径3cmのヘルニア門を認め，CT検査にて白線ヘルニアと両側鼠径ヘルニアを認めた．いずれもtransabdominal preperitoneal approach（以下，TAPP法）で修復し，現在まで問題なく経過している．TAPP法はメッシュ関連合併症を避けうる点で非常に有用な術式と思われる．

　Linea alba hernia is rare among ventral hernia. We report two patients with linea alba hernia treated by Transabdominal preperitoneal approach （TAPP） technique. Patient 1 is a 70-year-old man who have been complaining of epigastric swelling for 6 months. . Abdominal computed tomography showed a defect in the linea alba at upper abdomen. We diagnosed a linea alba hernia. Patient 2 is a 51-year-old man, who complained of epigastric swelling from 20 years ago, with recently added pain and burning sensation. He also complained of bilateral inguinal bulging.

　Abdominal computed tomography showed a defect in the linea alba and bilateral inguinal hernia. We diagnosed a linea alba hernia and bilateral inguinal hernia. Both patients were treated by laparoscopic TAPP technique. Postoperative course was uneventful.

　The TAPP method would be useful in avoiding mesh-related complication for linea alba hernia.