Single-incision totally extraperitoneal hernia repair with intraperitoneal inspection of strangulated femoral hernia at risk for intestinal ischemia after repositioning: a case report, Journal of Medical Case Reports

Background Totally extraperitoneal hernia repair and the transabdominal preperitoneal approach have advantages and disadvantages. We used the advantages of totally extraperitoneal hernia repair and the transabdominal preperitoneal approach and performed single-incision totally extraperitoneal hernia repair with intraperitoneal inspection for the treatment of strangulated femoral hernia in a patient at risk for intestinal ischemia. Case presentation We report a case of a 75-year-old Japanese woman who presented with black vomiting of 5 days’ duration. Physical examination revealed a right inguinal bulge and sharp pain. Computed tomography revealed a right strangulated femoral hernia with no intestinal ischemia. We were able to reposition the hernia; however, we performed the operation with consideration of the possibility of intestinal ischemia by incarceration of the intestine because the onset was 5 days previously. Intraperitoneal observation revealed a right femoral hernia and confirmed that the intestinal tract was not ischemic. However, the intestinal tract was expanded because of ileus, and securing a clear field of vision was difficult. Hence, we switched to totally extraperitoneal hernia repair at the same incision and performed single-incision totally extraperitoneal hernia repair with intraperitoneal inspection. The hernia sac was observed at the femoral rings and obturator foramen. The mesh was inserted through the incision, and after it was positioned to cover the Hesselbach triangle, femoral rings, inguinal ring, and obturator foramen, it was fixed with SECURESTRAP®. Observation of the abdominal cavity confirmed complete repair. After the operation, there was no recurrence or other complications. Conclusion We report a case of successful single-incision totally extraperitoneal hernia repair with intraperitoneal inspection for the treatment of strangulated femoral hernia in a patient at risk for intestinal ischemia after repositioning.

Abstracts from IPEG 2013The 22nd Annual Congress for Endosurgery

Surgical technique of laparoscopic hybrid approach for recurrent

111616 PDFs Review articles in HERNIA

JaypeeDigital

International Guidelines For Groin Hernia Management

2017 update of the WSES guidelines for emergency repair of

Laparoscopic view of Polysoft mesh in the preperitoneal space

Therapeutic efficacy of programmed spatial anatomy of the

Table 2 from TAAP vs. TEP in Inguinal Hernia Repair - What is the

Canadian Surgery Forum 201801. Laparoscopic splenectomy with

International Guidelines For Groin Hernia Management

PDF) Strangulated internal hernia caused by an iatrogenic

Transabdominal Pre-peritoneal Laparoscopic Hernia Repair Allows

International guidelines for groin hernia management

Femoral Hernia Surgery at Southlake General Surgery - Southlake General Surgery

Hernia, Inguinal hernia, Femoral hernia, Incisional hernia, Surgery

Open Femoral Hernia Releasing Incision. The yellow line marks the

Femoral Hernia: A Review of the Clinical Anatomy and Surgical Treatment

Femoral Hernia Repair - DoveMed