腹腔鏡下腟仙骨固定術（LSC）施行後に発症したメッシュが起因と思われる腸閉塞の一例

抄録

　Laparoscopic sacrocolpopexy (LSC) is a useful method to treat pelvic organ prolapse (POP).

　LSC has a lower incidence of POP recurrence, compared to native tissue repair (NTR), which was performed frequently in the past¹⁾. LSC is often in Japan performed on a nationwide scale because LSC has been covered by national insurance since 2016. Notably, reports on the long-term prognosis are limited. We managed a patient with bowel obstruction who required bowel resection due to mesh insertion during LSC. The patient was a 56-year-old woman. She underwent a LSC at 53 years of age, and developed a bowel obstruction that required bowel resection. Surgeons in another hospital performed emergency surgery for her ambulatory abdominal symptoms, which revealed that there was peritoneal pocket opening due to erosion of the mesh or incomplete reperitonealization at the time of LSC 3 years earlier. The surgeons resected the inserted mesh or an adhesional band-like fragment, which was composed of a hernial orifice and a part of the small intestine, because necrotic changes were observed. The surgeons decided that the pocket was not sutured. She made a good progress postoperatively and had no bowel obstruction recurrences for the present. Even though there are not many reports of bowel obstruction after LSC, bowel obstruction is a possible complication. We suggest evaluation for this potential complication for a long time after performing LSC.