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双侧经腹腹膜前修补术后复发性双侧腹股沟膀胱疝的腹腔镜修补术

Laparoscopic Repair for Recurrent Bilateral Inguinal Bladder Hernia following Bilateral Transabdominal Preperitoneal Repair.

作者信息

Umemura Akira, Suto Takayuki, Fujuwara Hisataka, Nakamura Seika, Nitta Hiroyuki, Takahara Takeshi, Hasegawa Yasushi, Sasaki Akira

机构信息

Department of Surgery, Morioka Municipal Hospital, Japan.

Department of Surgery, Iwate Medical University, Japan.

出版信息

Case Rep Surg. 2018 Dec 6;2018:4904093. doi: 10.1155/2018/4904093. eCollection 2018.

Abstract

INTRODUCTION

Although a recurrent inguinal hernia is sometimes observed as a supravesical hernia, it is extremely rare to encounter a bilateral bladder sliding hernia recurrence. In this report, we describe an extremely rare case of a recurrent bilateral supravesical bladder hernia after bilateral transabdominal preperitoneal repair (B-TAPP).

CASE PRESENTATION

A 69-year-old man visited our hospital with complaints of bilateral groin swelling and frequent voiding after B-TAPP. A plain CT revealed that the urinary bladder was herniating into the bilateral supravesical hernias. He underwent laparoscopic bilateral supravesical bladder hernia repair using a bladder takedown approach and median TAPP.

DISCUSSION

In Japan, the current mainstream method of hernioplasty is TAPP. However, an immature surgical technique and inadequate mesh placement may increase the risk of recurrent hernias. We successfully repaired this patient's recurrent bilateral supravesical bladder hernias laparoscopically.

CONCLUSION

This rare condition (recurrent bilateral supravesical bladder hernias after B-TAPP) was successfully treated by using the bladder takedown approach and median TAPP. During surgical training and later in clinical practice, surgeons should master a surgical technique for this procedure in order to reduce recurrent hernias.

摘要

引言

尽管复发性腹股沟疝有时表现为膀胱上疝,但双侧膀胱滑动疝复发极为罕见。在本报告中,我们描述了一例双侧经腹腹膜前修补术(B-TAPP)后复发性双侧膀胱上疝的极其罕见病例。

病例介绍

一名69岁男性因B-TAPP术后双侧腹股沟肿胀和尿频前来我院就诊。平扫CT显示膀胱疝入双侧膀胱上疝。他接受了采用膀胱下移法和正中TAPP的腹腔镜双侧膀胱上疝修补术。

讨论

在日本,目前疝修补术的主流方法是TAPP。然而,不成熟的手术技术和补片放置不当可能会增加复发性疝的风险。我们成功地通过腹腔镜修复了该患者复发性双侧膀胱上疝。

结论

这种罕见情况(B-TAPP术后复发性双侧膀胱上疝)通过采用膀胱下移法和正中TAPP成功得到治疗。在外科培训期间及之后的临床实践中,外科医生应掌握该手术的技术,以减少复发性疝的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a28/6304920/3064969208f8/CRIS2018-4904093.001.jpg

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