Department of Surgery, Kawasaki Saiwai Hospital, Kawasaki, Japan.
Asian J Endosc Surg. 2020 Jul;13(3):457-460. doi: 10.1111/ases.12739. Epub 2019 Jul 22.
Reports of recurrence after obturator hernia repair are few. We describe the case of an 89-year-old woman who presented to us with a thrice recurrent obturator hernia. She had undergone open non-mesh repair twice and then laparoscopic non-mesh repair. She was readmitted to our hospital 6 months after the laparoscopic repair. Manual reduction was successful, paving the way for elective transabdominal preperitoneal repair. During the endoscopic repair, surgical mesh was placed extraperitoneally over the hernia defect and then fixed to Cooper's ligament with absorbable tacks. The patient was discharged on postoperative day 2 without complications. In the 2 months that have passed since the surgery there has been no sign of recurrence, but the patient will be carefully followed up. Repair of a recurrent obturator hernia is technically challenging; however, the transabdominal preperitoneal approach seems to be reliable and safe.
闭孔疝修补术后复发的报道很少。我们描述了一例 89 岁女性患者,她曾三次复发闭孔疝。她曾接受过两次开放式无网片修补术和一次腹腔镜无网片修补术。在腹腔镜修补术后 6 个月,她再次入院。手法复位成功,为择期经腹腹膜前修补铺平了道路。在腔内修复过程中,手术网片被放置在疝缺损的腹膜外,并使用可吸收钉固定在库珀韧带。患者术后第 2 天出院,无并发症。手术以来的 2 个月内,没有复发的迹象,但患者将被密切随访。复发性闭孔疝的修补具有一定的技术挑战性;然而,经腹腹膜前入路似乎是可靠和安全的。