成人鼠径ヘルニアに対するクーゲル法導入の初期検討

Abstract

The Kugel repair is a minimally invasive but nonlaparoscopic hernia repair involving a preperitoneal approach. It is performed in both a tension-free and sutureless fashion through a small incision. It is effective in the treatment of primary and recurrent direct and indirect hernias, as well as fernoral hernias, using the same approach in each case. It has the advantage over other repairs in assuring a very low risk of recurrence. We introduced this method for adult groin hernia in August 2003. With 45 hernia repairs perfomled over an 8-month period of time since then, there has been no recurrence identified. There were only two cases of seroma, and one case of subcutaneous hematoma. No specific restrictions with regard to activity were placed on these patients after surgery. In almost all cases the patients were able to return to regular activities, including work, within a few days after surgery. This repair is an attempt to achieve the most rapid recovery possible after groin hernia surgery, and may be a more effective method when cost, ease of performance, and fast recovery are important considerations.