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腹腔镜腹腔内补片修补术治疗肾移植术后巨大切口疝 1 例报告。

Laparoscopic intraperitoneal mesh repair of a large incisional hernia in a kidney transplantation patient: A case report.

机构信息

Department of General and Digestive Surgery, Kanazawa Medical University Hospital, Kahoku, Japan.

出版信息

Asian J Endosc Surg. 2022 Jan;15(1):180-183. doi: 10.1111/ases.12954. Epub 2021 May 16.

DOI:10.1111/ases.12954
PMID:33993626
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9290791/
Abstract

A 73-year-old woman presented to our hospital because of painful bulging in the right lower abdomen, and developed a 17 × 12 cm incisional hernia after kidney transplantation using right oblique incision. Laparoscopic intraperitoneal onlay mesh (IPOM) repair was performed. Since a transplanted kidney is close to the abdominal wall defect, the space between the transplanted kidney and the abdominal wall was peeled off to secure enough space for the mesh to be place. After that the fascial defect was detected precisely, and the polypropylene-polyglycolic acid composite mesh was fixed with 3 cm overlapping of the hernia ring by non-absorbable tacks. The patient was discharged 9 days after surgery. In general, abdominal incisional hernias after kidney transplantation are relatively large with boundary defect of abdominal wall ensuing between the abdominal and allograft. However, laparoscopic IPOM repair of incisional hernia after kidney transplantation can be performed safely and effectively.

摘要

一位 73 岁女性因右下腹部疼痛性膨出就诊，在使用右斜切口进行肾移植后出现 17×12cm 的切口疝。行腹腔镜腹腔内补片（IPOM）修补术。由于移植肾靠近腹壁缺损，因此剥离移植肾与腹壁之间的空间，以确保补片有足够的空间放置。然后精确检测筋膜缺损，并使用不可吸收的钉书钉将聚丙烯-聚乙二醇酸复合补片固定在疝环上 3cm 重叠。患者在手术后 9 天出院。一般来说，肾移植后腹部切口疝较大，且存在腹壁与移植物之间的边界缺陷。然而，肾移植后切口疝的腹腔镜 IPOM 修补术可以安全有效地进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/9c570ce58754/ASES-15-180-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/9d7763253666/ASES-15-180-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/e3ff79f7ac6c/ASES-15-180-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/f700c5a7c8b4/ASES-15-180-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/9c570ce58754/ASES-15-180-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/9d7763253666/ASES-15-180-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/e3ff79f7ac6c/ASES-15-180-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/f700c5a7c8b4/ASES-15-180-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9185/9290791/9c570ce58754/ASES-15-180-g001.jpg

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本文引用的文献

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Surg Endosc. 2019 Oct;33(10):3069-3139. doi: 10.1007/s00464-019-06907-7. Epub 2019 Jun 27.
2
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