Single-incision totally extraperitoneal hernia repair with
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Background Totally extraperitoneal hernia repair and the transabdominal preperitoneal approach have advantages and disadvantages. We used the advantages of totally extraperitoneal hernia repair and the transabdominal preperitoneal approach and performed single-incision totally extraperitoneal hernia repair with intraperitoneal inspection for the treatment of strangulated femoral hernia in a patient at risk for intestinal ischemia. Case presentation We report a case of a 75-year-old Japanese woman who presented with black vomiting of 5 days’ duration. Physical examination revealed a right inguinal bulge and sharp pain. Computed tomography revealed a right strangulated femoral hernia with no intestinal ischemia. We were able to reposition the hernia; however, we performed the operation with consideration of the possibility of intestinal ischemia by incarceration of the intestine because the onset was 5 days previously. Intraperitoneal observation revealed a right femoral hernia and confirmed that the intestinal tract was not ischemic. However, the intestinal tract was expanded because of ileus, and securing a clear field of vision was difficult. Hence, we switched to totally extraperitoneal hernia repair at the same incision and performed single-incision totally extraperitoneal hernia repair with intraperitoneal inspection. The hernia sac was observed at the femoral rings and obturator foramen. The mesh was inserted through the incision, and after it was positioned to cover the Hesselbach triangle, femoral rings, inguinal ring, and obturator foramen, it was fixed with SECURESTRAP®. Observation of the abdominal cavity confirmed complete repair. After the operation, there was no recurrence or other complications. Conclusion We report a case of successful single-incision totally extraperitoneal hernia repair with intraperitoneal inspection for the treatment of strangulated femoral hernia in a patient at risk for intestinal ischemia after repositioning.
Toshiyuki ITAMOTO, Chief director, PhD
Takashi URUSHIHARA, Hiroshima University, Hiroshima
Robotic Assisted Single Incision Laparoscopic Total Extraperitoneal Bilateral Inguinal Hernia Repair
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Minimally Invasive Surgical Techniques for Inguinal Hernia Repair: The Extended-View Totally Extraperitoneal Approach (eTEP)
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Observation of the abdominal cavity revealed that the repair was
PDF) Laparoscopic Transabdominal Preperitoneal Inguinal Hernia
TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP), BMC Surgery
Laparoscopic view of Polysoft mesh in the preperitoneal space
Observation of the abdominal cavity revealed that the repair was
Toshiyuki ITAMOTO, Chief director, PhD
Single-incision laparoscopic transabdominal preperitoneal repair in the treatment of adult female patients with inguinal hernia