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机器人辅助腹腔镜根治性前列腺切除术后切口疝患者的增强视野完全腹膜外修补术:病例报告

Enhanced-view totally extraperitoneal repair in a patient with incisional hernia after robot-assisted laparoscopic radical prostatectomy: a case report.

作者信息

Honma Shusaku, Tanino Keisuke, Kumode Takashi, Mizuno Ryosuke, Matsui Yugo, Yao Siyuan, Murakami Teppei, Kan Takatsugu, Nakajima Sanae, Harada Takehisa

机构信息

Department of Surgery, Kobe City Medical Center West Hospital, 2-4, Ichibancho, Nagataku, Kobe, Hyogo, 653-0013, Japan.

出版信息

Surg Case Rep. 2022 Feb 7;8(1):28. doi: 10.1186/s40792-022-01380-2.

Abstract

BACKGROUND

Although laparoscopic incisional hernia repair, especially laparoscopic intraperitoneal onlay mesh, is a widely used technique, it can cause serious complications, including mesh erosion, adhesive bowel obstruction, and chronic pain. The enhanced-view totally extraperitoneal (eTEP) technique has been reported to prevent such complications by placing the mesh in the retrorectus space. Here, we report the case of a patient with post-robot-assisted laparoscopic radical prostatectomy (RARP) incisional hernia repaired using the eTEP technique.

CASE PRESENTATION

A 67-year-old man, who underwent RARP for prostate cancer 4 years ago developed an incisional hernia. Abdominal computed tomography showed the presence of an epigastric incisional hernia measuring 4 cm long and 3.7 cm wide. We performed an eTEP repair. We closed the hernia defect using a 0 barbed suture and placed a self-gripping mesh measuring 20 cm long and 15 cm wide in the developed retrorectus space with no fixation. There were no postoperative complications, and the patient was discharged on postoperative day 2.

CONCLUSIONS

eTEP repair is considered an extremely effective surgical treatment option for incisional hernias because of its few resulting postoperative mesh-and-tacker-related complications.

摘要

背景

尽管腹腔镜切口疝修补术,尤其是腹腔镜腹膜内补片植入术是一种广泛应用的技术,但它可能导致严重并发症,包括补片侵蚀、粘连性肠梗阻和慢性疼痛。据报道,增强视野完全腹膜外(eTEP)技术通过将补片放置在腹直肌后间隙来预防此类并发症。在此,我们报告一例使用eTEP技术修复机器人辅助腹腔镜根治性前列腺切除术(RARP)后切口疝的患者病例。

病例介绍

一名67岁男性,4年前因前列腺癌接受了RARP手术,之后出现了切口疝。腹部计算机断层扫描显示存在一个长4厘米、宽3.7厘米的上腹切口疝。我们进行了eTEP修补术。我们使用0号倒刺缝线关闭疝缺损,并在形成的腹直肌后间隙放置了一块长20厘米、宽15厘米的自固定补片,未进行固定。术后无并发症发生,患者于术后第2天出院。

结论

由于eTEP修补术术后与补片和钉合器相关的并发症较少,它被认为是治疗切口疝极为有效的手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8d/8821765/a0a3c5b5f303/40792_2022_1380_Fig1_HTML.jpg

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