A 74-year-old woman had undergone a laparoscopic inguinal hernia repair for bilateral inguinal hernia and a left femoral hernia at another hospital at the age of 73 years. She visited our hospital because of an intestinal obstruction seven months after surgery. Abdominal computed tomography showed a difference in diameter of the small intestine in the left lower quadrant. She was diagnosed as having bowel obstruction due to an adhesion, and an ileus tube was inserted. The symptoms did not resolve after 7 days, so surgery was performed. When the inside of the peritoneal cavity was observed laparoscopically, the small intestine adhered to the left inguinal region, and dilation of the oral side of the intestinal tract was confirmed. The mesh and tucker were firmly adhered to the intestinal tract. It was considered difficult to continue the operation laparoscopically, and the operation was converted to laparotomy. The mesh was detached from the small intestine, but stenosis and serosal damage were observed, and partial resection of the small intestine was performed. Since the mesh was retained without being folded, it was left intact. The peritoneal defect hole was sutured closed, and the operation was completed. After laparoscopic inguinal hernia repair, there is a possibility of intestinal obstruction due to detachment of the closed peritoneum. Strong suture closure without gaps is considered necessary at the time of peritoneal suture.
"},{"@language":"ja","@value":"症例は74歳，女性．平成28年に他院で両側鼠径ヘルニア，左大腿ヘルニアに対して腹腔鏡下鼠径ヘルニア修復術を施行された．術後7カ月目に腸閉塞を発症し来院した．CTでは左下腹部で小腸の口径差を認め，癒着性腸閉塞と診断し，イレウス管を挿入し保存的加療を行った．1週間の保存的加療を行うも改善しないため手術の方針とした．腹腔鏡下に腹腔内を観察したところ，左鼠径部のメッシュ留置部位に小腸が癒着し口側腸管の拡張を認めた．メッシュやタッカーと腸管が強固に癒着しており腹腔鏡下での手術継続は困難と考え，開腹手術へ移行した．メッシュと小腸の癒着剥離行ったが狭窄や漿膜損傷を認め，小腸部分切除術を施行した．メッシュはそのまま留置し，腹膜欠損孔は縫合閉鎖し手術を終了した．腹腔鏡下鼠径ヘルニア修復術後には閉鎖した腹膜の離開による腸閉塞をきたす可能性があり，腹膜縫合の際には隙間のない強固な縫合閉鎖が必要であると考えられた．
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410285300154846594","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000408912584"}],"foaf:name":[{"@language":"en","@value":"NAKAGAWA Yuki"},{"@language":"ja","@value":"中川 勇希"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Surgery, Ise Red Cross Hospital"},{"@language":"ja","@value":"伊勢赤十字病院外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410285300154846593","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000408912585"}],"foaf:name":[{"@language":"en","@value":"TAKAHASHI Koji"},{"@language":"ja","@value":"高橋 幸二"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"伊勢赤十字病院外科"},{"@language":"en","@value":"Department of Surgery, Ise Red Cross Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410285300154846595","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000408912586"}],"foaf:name":[{"@language":"en","@value":"FUJII Koji"},{"@language":"ja","@value":"藤井 幸治"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"伊勢赤十字病院外科"},{"@language":"en","@value":"Department of Surgery, Ise Red Cross Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410285300154846597","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000408912587"}],"foaf:name":[{"@language":"en","@value":"MATSUMOTO Eiichi"},{"@language":"ja","@value":"松本 英一"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"伊勢赤十字病院外科"},{"@language":"en","@value":"Department of Surgery, Ise Red Cross Hospital"}]},{"@id":"https://cir.nii.ac.jp/crid/1410285300154846592","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000408912588"}],"foaf:name":[{"@language":"en","@value":"MIYAHARA Shigeki"},{"@language":"ja","@value":"宮原 成樹"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Surgery, Ise Red Cross Hospital"},{"@language":"ja","@value":"伊勢赤十字病院外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410285300154846596","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000408912589"}],"foaf:name":[{"@language":"en","@value":"KUSUTA Tsukasa"},{"@language":"ja","@value":"楠田 司"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"伊勢赤十字病院外科"},{"@language":"en","@value":"Department of Surgery, Ise Red Cross Hospital"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13452843"},{"@type":"EISSN","@value":"18825133"},{"@type":"NDL_BIB_ID","@value":"000000107238"},{"@type":"ISSN","@value":"13452843"},{"@type":"LISSN","@value":"13452843"},{"@type":"NCID","@value":"AA11189709"}],"prism:publicationName":[{"@language":"en","@value":"Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)"},{"@language":"ja","@value":"日本臨床外科学会雑誌"},{"@language":"en","@value":"Nihon Rinsho Geka Gakkai Zasshi (J Jpn Surg Assoc)"},{"@language":"en","@value":"J Jpn Surg Assoc"},{"@language":"en","@value":"J. Jpn. Surg. Assoc."},{"@language":"ja","@value":"日臨外会誌"},{"@language":"en","@value":"Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)"},{"@language":"ja","@value":"日本臨床外科学会雑誌"}],"dc:publisher":[{"@language":"en","@value":"Japan Surgical Association"},{"@language":"ja","@value":"日本臨床外科学会"}],"prism:publicationDate":"2019","prism:volume":"80","prism:number":"10","prism:startingPage":"1854","prism:endingPage":"1858"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"http://id.ndl.go.jp/bib/030078852"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I030078852"},{"@id":"https://www.jstage.jst.go.jp/article/jjsa/80/10/80_1854/_pdf"},{"@id":"https://search.jamas.or.jp/link/ui/2020043709"}],"availableAt":"2019","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E8%85%B9%E8%85%94%E9%8F%A1%E4%B8%8B%E9%BC%A0%E5%BE%84%E3%83%98%E3%83%AB%E3%83%8B%E3%82%A2%E4%BF%AE%E5%BE%A9%E8%A1%93","dc:title":"腹腔鏡下鼠径ヘルニア修復術"},{"@id":"https://cir.nii.ac.jp/all?q=TAPP","dc:title":"TAPP"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%85%B8%E9%96%89%E5%A1%9E","dc:title":"腸閉塞"},{"@id":"https://cir.nii.ac.jp/all?q=laparoscopic%20inguinal%20hernia%20repair","dc:title":"laparoscopic inguinal hernia repair"},{"@id":"https://cir.nii.ac.jp/all?q=TAPP","dc:title":"TAPP"},{"@id":"https://cir.nii.ac.jp/all?q=intestinal%20obstruction","dc:title":"intestinal obstruction"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1362544419327801728","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Comparison of endoscopic techniques vs Shouldice and other open nonmesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials"}]},{"@id":"https://cir.nii.ac.jp/crid/1363388846145037440","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Preperitoneal herniation and bowel obstruction post laparoscopic inguinal hernia repair: case report and review of the literature"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2007774184"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I030078852"},{"@type":"CROSSREF","@value":"10.3919/jjsa.80.1854"},{"@type":"CIA","@value":"130007837850"},{"@type":"OPENAIRE","@value":"doi_dedup___::dbb21e2c53328ce4186a7b7dbd9dd2f0"}]}