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 If the bowel is necrotic, the damaged bowel loop is withdrawn through the wound and easily reconstructed extra-abdominally.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.
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 herniapatients 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: Jacqueline J Choi; Nandini C Palaniappa; Kai B Dallas; Tamara B Rudich; Modesto J Colon; Celia M Divino Journal: Ann Surg Date: 2012-01 Impact factor: 12.969
Authors: J I Rodríguez-Hermosa; A Codina-Cazador; A Maroto-Genover; J Puig-Alcántara; J M Sirvent-Calvera; E Garsot-Savall; J Roig-García Journal: Hernia Date: 2008-01-11 Impact factor: 4.739
Authors: D Schizas; K Apostolou; N Hasemaki; P Kanavidis; D Tsapralis; N Garmpis; C Damaskos; A Alexandrou; D Filippou; K Kontzoglou Journal: Hernia Date: 2020-08-09 Impact factor: 4.739