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造口旁疝的腹腔鏡手術

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討論一個困難又有趣的腹壁切口疝氣病例:79歲男性,13年前膀胱癌膀胱全切除,有 人工膀胱造口(ileo conduit ), 近年來造口旁逐漸膨出,有局部疼痛及腸阻塞症狀,外覌及CT如下,請問各位prefer何種手術治療?個人做過 translocation, open  及scope IPOM-plus keyhole, open  onlay, open sublay, 最近做了兩個 scope IPOM-plus Sugarbaker,我們繼續討論 ileo-conduit 造口旁疝的 Sugarbacker 修補使用的人工網  Ventralight ST 15x10 cm,價格NTS 15200, 腔鏡下adhesiolysis,reduction of incarcerated small bowel,確認 conduit位置及輸尿管接合處大概位置,以TCCFD技術関閉 疝孔後,以15x10cm Ventralight ST人工網覆蓋,一半長度覆蓋已關閉的切口疝並注意足夠的overlapping, 另一端以包埋方式將 conduit 人工膀胱固定扵 lateral abdominal wall, 注意開口的鬆緊度不能壓到輸尿管廻腸吻合處。l

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