Preperitoneal approach via a lower abdominal median incision for obturator hernia

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  • 閉鎖孔ヘルニアに対する下腹部正中小切開による腹膜前腔アプローチ
  • 臨床経験 閉鎖孔ヘルニアに対する下腹部正中小切開による腹膜前腔アプローチ
  • リンショウ ケイケン ヘイサコウ ヘルニア ニ タイスル カフクブ セイ チュウショウ セッカイ ニ ヨル フクマク ゼンコウアプローチ

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It is believed that obturator hernias predominate in slender aged women. Incarceration of the intestine into the obturator foramen can frequently cause intestinal obstruction with resultant circulatory disturbance. It demands emergency treatment and early diagnosis is important. However, obturator hernia lacks in physical findings which can be observed from the surface of the body and is comparatively rare, so that the disease is liable to be overlooked. In a series of 132 cases undergone emergency operation with the diagnosis of intestinal obstruction in our hospital for the past three years, obturator hernias represented 9.1% (12 cases), showing a fact that the patients with the disease accounted for some ratio in the total ileus patients. All the 12 patients could be diagnosed by symptoms, detailed questioning, and abdominal CT scanning. In performing surgery for the disease, we often have difficulties in repairing the hernia opening. In our institution, we employ the mesh repair even for patients who require bowel resection by applying our own devices in which the hernia opening is repaired by the preperitoneal approach via a small lower abdominal median incision. Compared to the conventional inguinal approach or lower abdominal median laparotomy, this approach has many advantages and appears to be a rationale and valuable operative procedure.

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