Laparoscopic femoral hernia repair using umbilical ligament as plug.

A novel technique for the laparoscopic repair of femoral hernia is described. An 11-year-old boy who had undergone previous open inguinal herniorrhaphy presented with a persistent bulge in the ipsilateral groin. At laparoscopic exploration, a small femoral hernia was discovered. It was reduced with extrinsic compression and the defect closed laparoscopically using a permanent purse-string suture. The ipsilateral umbilical ligament was dissected off the abdominal wall and secured (plugged) over the internal opening, providing a tension-free repair. The immediate postoperative result was satisfactory and there was minimal postoperative pain. Two-year follow-up confirmed adequate repair, without recurrence. This laparoscopic technique enabled diagnostic precision, contralateral evaluation, and a novel means of patching and buttressing the peritoneal closure with umbilical ligament. The procedure is safe, simple, and provides excellent functional and cosmetic results.