Minimal incision transinguinal repair for incarcerated obturator hernia.

Abstract

BACKGROUND:

Patients with incarcerated obturator hernia are usually elderly, frail, and physically inactive women with serious comorbidities. Although a laparotomy is standard surgical intervention for emergency incarcerated or strangulated obturator hernia, it is invasive particularly for these high-risk patients. The aim of this study is to show the feasibility of minimum open inguinal approach to reduce surgical risk for preoperatively diagnosed incarcerated obturator hernia.

METHODS:

Between April 2008 and July 2012, 3 consecutive incarcerated obturator hernia patients at Kamitsuga General Hospital who were diagnosed preoperatively by computed tomography underwent the following procedure. First a 4 cm inguinal hernia incision and preperitoneal dissection through the opening of the deep inguinal ring are made. The obturator hernia can be easily found 2 cm dorsally from the Cooper's ligament extraperitoneally. A small incision is made at medial sharp edge of the hernia defect. The hernia sac and its content can then be reduced. If the incarcerated bowel is viable, a prosthetic mesh is placed as a patch. If the bowel is necrotic, the damaged bowel loop is withdrawn through the wound and easily reconstructed extra-abdominally.

RESULTS:

All operations were successfully completed with this procedure. All patients recovered without incident.

CONCLUSIONS:

Minimal incision transinguinal repair for diagnosed incarcerated obturator hernia is feasible and provides an improved option to more invasive procedures.

• Authors: Y Togawa, T Muronoi, H Kawaguchi, T Chiku, W Sano, T Hashiba, A Ueda, K Kaneoya
• Journal: Hernia : the journal of hernias and abdominal wall surgery (Hernia) Vol. 18 Issue 3 Pg. 407-11 (Jun 2014) ISSN: 1248-9204 [Electronic] France
• PMID: 23644742 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Female
• Hernia, Obturator (complications, surgery)
• Herniorrhaphy (methods)
• Humans
• Intestinal Obstruction (etiology, pathology, surgery)
• Intestines (blood supply)
• Minimally Invasive Surgical Procedures
• Surgical Mesh