論文

査読有り 国際誌
2020年10月1日

Needlescopic surgery for large umbilical hernia in a patient with morbid obesity using intraperitoneal onlay mesh with fascial defect closure: a case report.

Surgical case reports
  • Hisataka Fujiwara
  • ,
  • Takayuki Suto
  • ,
  • Akira Umemura
  • ,
  • Yota Tanahashi
  • ,
  • Satoshi Amano
  • ,
  • Kenichiro Ikeda
  • ,
  • Kazuho Harada
  • ,
  • Akira Sasaki

6
1
開始ページ
246
終了ページ
246
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s40792-020-01005-6

BACKGROUND: The European and American guidelines recommend that symptomatic umbilical hernias (UHs) are repaired using an open approach with a preperitoneal flat mesh. However, the standard treatment procedure for large UH in patients with extreme obesity is yet to be established. Here, we present the first case of a patient with morbid obesity undergoing laparoscopic UH repair using needlescopic instruments and an intraperitoneal onlay mesh plus repair (IPOM plus). CASE PRESENTATION: A 29-year-old man, who was classified as morbidly obese (body mass index, 36.7 kg/m2) noticed a reducible nontender mass in the umbilical region and was subsequently diagnosed with an UH, with a diameter of 4 cm. Laparoscopic IPOM plus repair was planned using a needlescopic method for a large UH in the patient with morbid obesity. A 3-mm rigid laparoscope was mainly used in the procedure. After a 12-mm trocar and two 3-mm trocars were inserted, fascial defect closure was performed using intracorporeal suturing with 0 monofilament polypropylene threads. Then, IPOM was performed laparoscopically using an 11.4-cm round mesh coated with collagen to prevent adhesions. The operative time and blood loss were 57 min and 1 g, respectively. The postoperative course was uneventful. CONCLUSIONS: Reduced-port laparoscopic surgery using needlescopic instruments and an IPOM plus technique is a minimally invasive and convenient combination option for large UH in a patient with morbid obesity.

リンク情報
DOI
https://doi.org/10.1186/s40792-020-01005-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33000428
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527381

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