A Case of Bilateral Abdominal Incisional Hernia Developed after a Pfannenstiel Incision

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  • Pfannenstiel切開後に発生した両側性腹壁瘢痕ヘルニアの1例
  • 症例 Pfannenstiel切開後に発生した両側性腹壁瘢痕ヘルニアの1例
  • ショウレイ Pfannenstiel セッカイ ゴ ニ ハッセイ シタ リョウソクセイ フクヘキハンコン ヘルニア ノ 1レイ

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Abstract

The case involved a 73-year-old woman who underwent total abdominal hysterectomy and bilateral adnexectomy by means of the Pfannenstiel incision for an ovarian cyst and myoma of the uterus in August 2014. The patient developed bulging and a sense of discomfort in the lower abdomen from around March 2015, and was referred to our hospital. An abdominal CT scan showed each one abdominal incisional hernia at the bilateral lower quadrants of abdomen. Surgery was planned and the patient underwent laparoscopic radical repair of the abdominal incisional hernia in April of the year. The both hernia orifices were situated at the lateral aspect of the rectus muscle of abdomen and inward and upward of medial aspect of the inguinal fossa. The mesh was fixed to the abdominal wall by the Duoble Crow method using a tacker cranially ; and caudally, in order to avoid to fix the mesh above the bladder, the peritoneum was incised, the mesh was spread over the preperitoneal space, and the mesh was fixed to the Cooper ligament, rectus muscle of abdomen and transverse muscle of abdomen by using a tacker, followed by suture and fixation of the peritoneum to the mesh. The patient's postoperative course was uneventful and no recurrence has occurred. This paper deals with our experience of a case of abdominal incisional hernia after a Pfannenstiel incision, which is a rare incisional hernia.

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