Laparoscopic repair of an incarcerated right indirect sliding inguinal hernia involving a retroperitoneal ileum.

INTRODUCTION: Laparoscopic techniques for the repair of inguinal hernias have become an increasingly popular alternative to open techniques. No clear consensus has emerged as to the best laparoscopic technique, but the body of evidence increasingly favors a total extraperitoneal (TEP) approach. RESULTS AND DISCUSSION: We report the case of an adult man with an incarcerated right indirect inguinal sliding hernia involving the first known instance of a retroperitoneal ileum, and the novel use of a laparoscopic combined TEP approach and transabdominal preperitoneal (TAPP) approach to repair his hernia without complications. The literature is reviewed and TEP and TAPP techniques for the treatment of inguinal hernias are discussed and compared.
CONCLUSION: When faced with an unforeseen anomaly during herniorrhaphy in which improved abdominal visualization is necessary, a surgeon may convert from a TEP to a transabdominal laparoscopic approach safely and effectively.