Ishikawa Takahisa, Nishikawa Makoto, Nakamoto Hiroki, Yokoyama Ryoji, Taketomi Akinobu
Department of Surgery, Hokkaido Prefectural Welfare Federation of Agricultural Cooperatives Abashiri-Kosei General Hospital, Abashiri, Japan.
Gastroenterological Surgery I, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
Asian J Endosc Surg. 2019 Apr;12(2):211-213. doi: 10.1111/ases.12618. Epub 2018 Jun 28.
Chronic pain after laparoscopic percutaneous extraperitoneal closure is very rare. Here, we report a case of chronic pain after laparoscopic percutaneous extraperitoneal closure in an adolescent patient with inguinal hernia who underwent open repair. A 15-year-old girl was diagnosed with a left indirect inguinal hernia, and laparoscopic percutaneous extraperitoneal closure was performed. However, 6 months later, after strenuous exercise, she developed localized pain around the hernia site. Her pain was well controlled by internal treatment but failed to completely resolve. The pain type was somatic, Tinel's sign was negative, and there was no recurrence of the inguinal hernia. Because she strongly wished to undergo surgery, the Potts procedure with removal of the ligature and excision of the round ligament was performed. Her pain improved after surgery, and further medical treatment was not required. The Potts procedure may be an effective treatment for chronic pain such as in this case.
腹腔镜经皮腹膜外修补术后慢性疼痛非常罕见。在此,我们报告一例青少年腹股沟疝患者在接受开放修补术后行腹腔镜经皮腹膜外修补术出现慢性疼痛的病例。一名15岁女孩被诊断为左侧腹股沟斜疝,并接受了腹腔镜经皮腹膜外修补术。然而,6个月后,剧烈运动后,她在疝部位周围出现局部疼痛。她的疼痛通过内科治疗得到了很好的控制,但未能完全缓解。疼痛类型为躯体性疼痛,Tinel征阴性,腹股沟疝无复发。由于她强烈希望接受手术,遂行Potts手术,切除结扎线并切除圆韧带。术后她的疼痛有所改善,无需进一步药物治疗。Potts手术可能是治疗此类慢性疼痛的有效方法。