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 eTEP-TARの応用

横径10 cmを超える瘢痕ヘルニアに対する修復術

著者： 蛭川浩史¹

所属機関： ¹立川綜合病院外科

ページ範囲：P.440 - P.447

【ポイント】
◆横径10 cmを超える腹壁瘢痕ヘルニアは，複雑なヘルニアに分類される．
◆腹腔鏡による修復術の適応をよく考慮すべきである．
◆修復術を行う際には，transversus abdominis muscle release（TAR）の手技は必須で，腹壁の解剖理解は重要である．
＊本論文中、［▶動画］マークのある図につきましては、関連する動画を見ることができます（公開期間：2026年4月末まで）。

参考文献

1）Bittner R, Bingener-Casey J, Dietz U, et al；International Endohernia Society（IEHS）：guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias（International Endohernia Society（IEHS）-part 1. Surg Endosc 28：2-29, 2014

2）Bittner R, Bain K, Bansal VK, et al：Update of guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias（International Endohernia Society（IEHS））-part A. Surg Endosc 33：3069-3139, 2019

3）Bittner R, Bain K, Bansal VK, et al：Update of guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias（International Endohernia Society（IEHS））：part B. Surg Endosc 33：3511-3549, 2019

4）Yeste JSP, Riquelme-Gaona J：When transversus abdominis release（TAR）is not enough during the repair of large midline incisional hernias：the double peritoneal flap to the rescue. Updates Surg 74：2031-2037, 2022

5）Chevrel J, Rath R：Classification of incisional hernias of the abdominal wall. Hernia 4：7-11, 2000

6）Muysoms FE, Miserez M, Berrevoet F, et al：Classification of primary and incisional abdominal wall hernias. Hernia 13：407-414, 2019

7）Deerenberg EB, Timmermans L, Hogerzeil DP, et al：A systematic review of the surgical treatment of large incisional hernia. Hernia 19：89-101, 2015

8）Kesicioglu T, Yildirim K, Yuruker S, et al：Three-year outcome after anterior component separation repair of giant ventral hernias：a retrospective analysis of the original technique without mesh. Asian J Surg 45：1117-1121, 2022

9）Passot G, Villeneuve L, Sabbagh C, et al：Definition of giant ventral hernias：development of standardization through a practice survey. Int J Surg 28：136-140, 2016

10）Slater NJ, Montgomery A, Berrevoet F, et al：Criteria for definition of complex abdominal wall hernia. Hernia 18：7-17, 2014

11）Oprea V, Mardale, Buia F, et al：The influence of transversus abdominis muscle release（TAR）for complex incisional hernia repair on the intraabdominal pressure and pulmonary function. Hernia 25：1601-1609, 2021

12）Parker SG, Halligan S, Liang MK, et al：Definitions for loss of domain：an International Delphi Consensus of Expert Surgeons. World J Surg 44：1070-1078, 2020

13）Sabbach C, Dummont T, Robert B, et al：Peritoneal volume is predictive of tension-free fascia closure of large incisional hernias with loss of domain：a prospective study. Hernia 15：559-565, 2011

14）Liang MK, Holihan JL, Itani K, et al：Ventral hernia management：expert consensus guided by systematic review. Ann Surg 265：80-89, 2017

15）Jensen KK, East B, Jisova B, et al： The European Hernia Society Prehabilitation Project： a systematic review of patient prehabilitation prior to ventral hernia surgery. Hernia 26： 715-726, 2022

16）Perez JE, Schmidt MA, Narvaez A, et al：Evolving concepts in ventral hernia repair and physical therapy：prehabilitation, rehabilitation, and analogies to tendon reconstruction. Hernia 25：1-13, 2021

17）Holihan JL, Askenasy EP, Greenberg JA, et al：Component separation vs. bridged repair for large ventral hernias：a multi-institutional risk-adjusted comparison, systematic review, and meta-analysis. Surg Infect（Larchmt）17：17-26, 2016

18）Majumder A, Martin-Del-Campo LA, Miller HJ, et al：Evaluation of anterior versus posterior component separation for hernia repair in a cadaveric model. Surg Endosc 34：2682-2689, 2020

19）Majumder A, Miller HJ, Del Campo LM, et al：Assessment of myofascial medialization following posterior component separation via transversus abdominis muscle release in a cadaveric model. Hernia 22：637-644, 2018

20）Radu VG, Lica M：The endoscopic retromuscular repair of ventral hernia：the eTEP technique and early results. Hernia 23：945-955, 2019

21）Binggen L, Qin C, Bittner R：Totally endoscopic sublay（TES）repair for midline ventral hernia：surgical technique and preliminary results. Surg Endosc 34：1543-1550, 2020

22）Lopez-Monclus J, Muñoz-Rodríguez J, Miguel CS, et al：Combining anterior and posterior component separation for extreme cases of abdominal wall reconstruction. Hernia 24：369-379, 2020

23）Oprea V, Matei O, Gheorghescu D, et al：Progressive preoperative pneumoperitoneum（PPP）as an adjunct for surgery of hernias with loss of domain. Chirurgia（Bucur）109：664-669, 2014

24）Patel NG, Ratanshi I, Buchel EW：The best of abdominal wall reconstruction. Plast Reconstr Surg 141：113e-136e, 2018

25）Zendejas B, Khasawneh MA, Srvantstyan B, et al：Outcomes of chemical component paralysis using botulinum toxin for incisional hernia repairs. World J of Surg 37：2830-2837, 2013

26）Karthikeyan VS, Sistla SC, Ram D, et al：Giant inguinoscrotal hernia—report of a rare case with literature review. Int Surg 99：560-564, 2014

27）Touroff AS：Phrenicetomy as aid to repair of large abdominal hernias. J Am Med Assoc 154：330-332, 1954