Department of Surgery, Toyama Red Cross Hospital, Toyama, Japan.
Asian J Endosc Surg. 2024 Jul;17(3):e13352. doi: 10.1111/ases.13352.
We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79-year-old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug-and-patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases.
我们报告一例复发性腹股沟膀胱疝,该患者曾三次接受手术治疗但均未成功,后采用完全腹膜外修补术(TEP)进行修复。一名 79 岁男性因右侧腹股沟肿胀就诊,该侧曾三次接受前入路手术治疗。计算机断层扫描(CT)证实为复发性腹股沟膀胱疝。术前确定为膀胱疝后,采用经前入路的 plug-and-patch 技术进行 TEP,此前的三次手术均采用该技术。腹膜外入路可在不损伤膀胱的情况下将其还纳,并使用 3D Max® Light Mesh 安全地修复疝。术后恢复顺利,1 年后无复发。TEP 有助于膀胱疝的诊断和修复,强调了术前诊断的重要性以及内镜手术在膀胱疝修复中的有效性,即使是在复发性病例中也是如此。