Department of Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
Asian J Endosc Surg. 2022 Oct;15(4):816-819. doi: 10.1111/ases.13076. Epub 2022 May 9.
An 80-year-old woman presented to our emergency department with vomiting which had begun half a day prior to presentation. She had undergone open mesh plug repair for a right obturator hernia 1 year prior to presentation. Computed tomography detected recurrence of the right obturator hernia. Since intestinal viability was maintained, manual reduction of the incarcerated intestine was performed. The patient was admitted to our department to monitor delayed intestinal perforation. Laparoscopic transabdominal preperitoneal repair for obturator hernia was performed 5 days after admission. A self-fixating mesh was placed over the obturator hernia defect and femoral ring without tacking. The patient was discharged on postoperative day 6 without postoperative complications. At the 4-month follow-up, no signs of hernia recurrence or neuropathy were observed. Laparoscopic transabdominal preperitoneal repair for recurrent obturator hernia status post-open mesh plug repair by using self-fixating mesh is a safe and suitable procedure.
一位 80 岁女性因呕吐就诊于我院急诊科,呕吐于就诊前半天开始。她在就诊前 1 年曾因右侧闭孔疝行开放网塞修补术。计算机断层扫描(CT)发现右侧闭孔疝复发。由于肠管活力得以维持,行手法复位嵌顿肠管。患者入院以监测迟发性肠穿孔。入院后 5 天行腹腔镜经腹腹膜前修补术(TAPP)治疗闭孔疝。自固定补片覆盖闭孔疝缺损和股环,未进行固定。患者术后第 6 天出院,无术后并发症。在 4 个月随访时,未观察到疝复发或神经病迹象。使用自固定补片的腹腔镜经腹腹膜前修补术治疗开放网塞修补术后复发性闭孔疝是一种安全且合适的术式。