腹腔鏡手術後に発生したポートサイトヘルニアに関する検討

抄録

  Port-site hernia (PSH) rarely complicates laparoscopic gynecological surgery. We perform approximately 200 laparoscopic surgeries annually at our facility; we report three cases of PSH that occurred after laparoscopic gynecological surgery over the past 4 years. PSH occurred in two patients after laparoscopic surgery for endometrial cancer and in one patient after total laparoscopic hysterectomy. These three cases represent 0.54% of all 558 laparoscopic surgeries performed at our facility between January 2016 and March 2019.

  We investigated patients' background, including age, body mass index, history of delivery, as well as surgical details, including operation time, estimated volume of blood loss, diameter of port site, and methods of wound closure. Two of the three patients were aged ≥65 years, and multiparity was the only factor common across all cases. The diameter of the port site at which PSH occurred was 12 mm in all patients, and fascial defects were closed using absorbable sutures. All patients developed small intestinal herniation. Hernia repair was performed via open surgery or the pushback method, or the hernia resolved spontaneously. PSH did not recur in any patient. Clinicians should consider the possibility of PSH after laparoscopic surgery.