Hsieh Kun-Chou, Chou Fong-Fu
Department of Surgery, E-Da Hospital, Yan-Chau Shiang, Kaohsiung City, Taiwan.
Surg Laparosc Endosc Percutan Tech. 2012 Apr;22(2):e105-8. doi: 10.1097/SLE.0b013e3182479632.
McBurney's incisional hernia after appendectomy is rare. Although the open surgical approach, either through direct suturing or through mesh repairs, mostly achieves a satisfactory outcome, postoperative wound pain usually impedes patient's early ambulation. Accordingly, laparoscopic ventral hernia repair has emerged as a minimally invasive technique in modern surgical practice. We described a different approach of laparoscopic incisional hernia repair.
A 76-year-old woman with a history of appendectomy presenting with a bulging mass over the right lower quadrant of the abdomen beneath the operation scar was admitted to our hospital. Computed tomography revealed defects in the abdominal muscle layers without evidence of bowel incarceration. The patient was diagnosed with postappendectomy incisional hernia for which laparoscopic hernia repair was performed through a combined intraperitoneal and extraperitoneal approach. The patient's postoperative course was excellent.
Combined extraperitoneal approach and intraperitoneal monitoring for McBurney's incisional hernia is feasible in selected cases.
阑尾切除术后麦氏切口疝较为罕见。尽管开放手术方式，无论是直接缝合还是使用补片修补，大多能取得满意的效果，但术后伤口疼痛通常会妨碍患者早期活动。因此，腹腔镜腹疝修补术已成为现代外科手术中的一种微创技术。我们描述了一种不同的腹腔镜切口疝修补方法。
一名76岁有阑尾切除术史的女性，因手术瘢痕下方右下腹出现肿块而入住我院。计算机断层扫描显示腹部肌肉层有缺损，无肠管嵌顿迹象。该患者被诊断为阑尾切除术后切口疝，通过腹腔内和腹膜外联合入路进行了腹腔镜疝修补术。患者术后恢复良好。
对于麦氏切口疝，在特定病例中采用腹膜外联合入路和腹腔内监测是可行的。
