臨床外科78巻4号

2023年04月発行

総特集 腹壁ヘルニア修復術の新潮流—瘢痕ヘルニア・臍ヘルニア・白線ヘルニア

総論

腹壁ヘルニア手術の最新のトレンド—腹壁瘢痕ヘルニアを中心に

著者： 諏訪勝仁¹

所属機関： ¹東京慈恵会医科大学附属第三病院外科

ページ範囲：P.400 - P.405

文献概要

【ポイント】
◆現時点で最も行われている腹壁ヘルニア修復術は腹壁切開法によるretromuscular（sublay, Rives-Stoppa）法と腹腔鏡下intraperitoneal onlay mesh（IPOM）法であり，新たな術式の比較対象となるgold standardである．
◆メッシュ留置部位は，メッシュと腹腔内臓器の直接接触による臓器障害やその後の腹部手術への悪影響などの理由により，IPOMから腹膜外留置法へシフトしている．
◆白線の再構築（ヘルニア門閉鎖）は，再発率や合併症発生率低減，mesh bulging抑制，腹壁機能改善の観点から推奨される．

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