下腹部の腹壁瘢痕ヘルニアに対してendoscopic mini/less open sublay repairを施行した1例

A case of endoscopic mini/less open sublay repair for abdominal incisional hernia

◆要旨：症例は73歳，男性．腹部大動脈瘤に対する人工血管置換術と腸閉塞解除術の既往があり，腸閉塞解除術の後に腹壁瘢痕ヘルニアを発症した．当初は経過観察されていたが，徐々にヘルニアが大きくなり生活への支障を認めることから修復術を施行した．手術はendoscopic mini/less open sublay repair（eMILOS）により修復し，transversus abdominis muscle release（TAR）を行った．術後に漿液腫を発症したが，外来での穿刺処置により消失した．術後半年が経過したが再発は認めていない．

　The patient was a 73-year-old man. He had a history of an aortic replacement with a Y-shaped vascular prosthesis for abdominal aortic aneurysm and a subsequent intestinal obstruction surgery. After the second laparotomy, he developed an incisional hernia. Although he was followed up initially, the hernia gradually became larger, and he underwent repair surgery when it started to interfere with his daily life. He underwent endoscopic mini/less open sublay repair（eMILOS） and a transversus abdominis muscle release（TAR）. He developed a postoperative seroma, which improved after an outpatient puncture drainage. Half a year has passed since the surgery without recurrence.