Two cases of incarcerated obturator hernia repaired by laparoscopic-assisted intraperitoneal with totally extraperitoneal approach

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Case 1 involved a 97-year-old woman complaining of abdominal pain and vomiting. She was diagnosed as having a right incarcerated obturator hernia by abdominal CT scan and underwent emergency operation. Laparoscopic observation revealed the right obturator hernia with an incarcerated small bowel within the hernia sac and a femoral hernia as well. After the incarcerated small bowel was reduced, the hernia was repaired by laparoscopic totally extraperitoneal (TEP) approach. Observation under re-pneumoperitoneum showed no necrosis in the incarcerated bowel and the surgical wound was closed. <BR>Case 2 involved a 93-year-old woman complaining of abdominal pain and vomiting. She was diagnosed as having a right incarcerated obturator hernia and was emergently operated on. Laparoscopic observation revealed an incarcerated small bowel within the right obturator hernia, as well as bilateral femoral hernias and a left obturator hernia. After the incarcerated small bowel was reduced, the bilateral hernias were repaired by TEP approach. Observation under re-pneumoperitoneum disclosed a necrotic portion in the incarcerated small bowel. Extracorporeal resection of the necrotic portion was performed, followed by anastomosis and closure.<BR>This paper deals with successful TEP associated with intraperitoneal approach for incarcerated obturator hernia in two cases, together with a review of the literature.
日本臨床外科学会の論文