モルガーニヘルニアの腹腔鏡下鼠径ヘルニア修復術（TAPP）による成功例：症例報告

Morgagni hernia (MH) is a rare diaphragmatic hernia caused by a parasternal defect. We report a case of MH that was successfully repaired using a laparoscopic transabdominal preperitoneal (L-TAPP) approach combined with a self-gripping mesh. A 76-year-old woman was incidentally diagn4osed with MH during a preoperative evaluation of an unrelated knee surgery. Computed tomography revealed herniation of the greater omentum through a diaphragmatic defect measuring ~5 cm × 5 cm. L-TAPP was performed, in which the hernia contents were reduced and wide peritoneal dissection enabled tension-free mesh placement in the extraperitoneal space using a self-gripping mesh. The postoperative course was uneventful, and the patient was discharged on postoperative Day 5, with no recurrence observed at 10 months of follow-up. The L-TAPP approach allows secure mesh placement without direct contact with the intra-abdominal organs, potentially reducing the risk of recurrence and intraperitoneal complications. L-TAPP combined with a self-gripping mesh may be a useful and minimally invasive treatment option for MH.