Case report: Laparoscopic totally extraperitoneal repair of an obturator hernia with self-gripping mesh under spinal anaesthesia

Petrushnko, Wilson; Isaacs, Anna; Hackland, Tony; Ghusn, Michael

doi:10.1016/j.ijscr.2019.07.048

Cited by 5 publications

(11 citation statements)

References 15 publications

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“…In 1724 Arnaud de Ronsil described obturator hernias for the first time [ 3 ]. However, it was only in 1851 that Henry Obre performed the first successful surgical repair [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Obturator hernia occurs more commonly in emaciated, older women [ 1 ], ages of 70–90, [ 4 ], chronically ill patients [ 2 ], and women who are multiparous, and is more prevalent in Asian countries [ 6 ]. Women have about 9 times higher risk of having an obturator hernia compared to men [ 5 , 7 , 8 ]; this can be explained by a wider pelvis, a larger obturator canal, and the tendency for the pelvic peritoneum to become looser [ 3 ]. As a result, obturator hernia has the eponym “little old lady´s hernia” [ 2 , 4 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Obturator hernia is an uncommon subtype of hernia of the abdominal wall, representing about 0.07–1% of all abdominal wall hernias [ 1 – 5 ]. Its incarceration is a rare cause of mechanical intestinal obstruction (0.2–1.6%) [ 3 , 4 ]. Obturator hernias have a higher incidence in elderly women (70–90%) [ 1 – 8 ] from Asian countries [ 4 , 5 ] and those who are malnourished [ 1 , 2 , 4 – 7 ] or multiparous [ 2 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The hernia sac usually contains the small intestine; however, it may rarely contain the appendix, colon, Meckel’s diverticulum, or epiploon [ 2 , 6 ]. Obturator hernia diagnosis is challenging due to its rarity and its signs and symptoms being often unspecific, leading to a delay in diagnosis and treatment [ 1 – 3 , 5 , 7 ]. Surgical repair is the standard treatment for this condition, and multiple approaches have been described [ 1 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty

et al. 2021

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Patient: Female, 93-year-old Final Diagnosis: Incarcerated obturator hernia Symptoms: Diffuse abdominal pain Medication:— Clinical Procedure: Hernioplasty Specialty: Surgery Objective: Rare disease Background: Obturator hernia is an uncommon (0.07-1% incidence rate) subtype of hernia of the abdominal wall, with its incarceration being a rare cause of bowel obstruction. Obturator hernia has a higher incidence in elderly women and in malnourished people. This type of hernia has the highest morbidity and mortality rates of all abdominal wall hernias. This article reports a case of an emaciated 93-year-old woman who presented with small bowel obstruction due to incarcerated obturator hernia, successfully managed surgically with a modified mesh-plug hernioplasty. Case Report: An emaciated 93-year-old woman presented with diffuse abdominal pain, more intense on the right iliac fossa, radiating to the right thigh, with 8-h evolution and associated with dark-colored vomiting but normal bowel transit. This patient had a surgical history of right Richter´s femoral hernia, strangulated, with previous intestinal resection and a right femoral hernioplasty. A computed tomography (CT) scan revealed an incarcerated obturator hernia on the right side containing a short segment of small intestine. The patient underwent an exploratory laparotomy and a mesh-plug hernioplasty. During follow-up, there was no evidence of recurrence or complications. Conclusions: Obturator hernia diagnosis is challenging due to its rarity and its signs and symptoms being often unspecific. CT scan has the highest sensitivity and is the best diagnostic tool. Surgical management is the only possible treatment for obturator hernia. Awareness of this condition is essential to allow an earlier approach and attempt to mitigate the associated high morbidity and mortality rates.

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“…In 1724 Arnaud de Ronsil described obturator hernias for the first time [ 3 ]. However, it was only in 1851 that Henry Obre performed the first successful surgical repair [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty

et al. 2021

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“…[ 10 , 18 ] Obturator hernia can also be diagnosed and treated by laparoscopic surgery, with both transabdominal and extraperitoneal approach. [ 15 , 21 – 23 ] This minimally invasive surgical approach enables visualization of the myopectineal orifice and identification of the presence of a synchronous contralateral obturator hernia. Laparoscopic surgery may also provide additional benefits for high-risk patients, such as shorter hospital stay, less postoperative ileus and pain, and fewer pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

Obturator hernia

Park

2020

Medicine

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Obturator hernia is a relatively rare type of abdominal hernia, in which abdominal contents protrude through the obturator canal, a condition that can lead to small bowel obstruction. Its rarity and nonspecific signs and symptoms make a preoperative diagnosis difficult. The present study analyzed the clinical manifestations, diagnostic methods and operative treatment outcomes in patients with obturator hernia. Between January 2012 and October 2019, 1028 adults underwent surgical repair of abdominal wall hernia at the Department of Surgery, Kyungpook National University Hospital. The medical records of eleven patients who were treated for small bowel obstruction due to obturator hernia were retrospectively evaluated. Patient characteristics, clinical presentation, preoperative radiological diagnosis, operative findings, treatment, complications, and outcomes were recorded. All 11 patients were elderly women, with a mean age of 80.2 years (range, 71–87 years). Their mean body mass index was 17.9 kg/m 2 (range, 11.9–22.2 kg/m 2 ). Symptoms at presentation were abdominal pain and vomiting, with a mean duration of symptoms prior to admission of 5.6 days (range, 1–15 days). Based on abdominopelvic computed tomography (CT) scans, all 11 patients were preoperatively diagnosed with obturator hernia, followed by laparoscopic exploration or laparotomy as soon as possible. Of the 11 patients, 6 (54.5%) had left-sided, four (36.4%) had right-sided, and one (9.1%) had bilateral obturator hernias. Three patients (27.3%) required resection of the ileum due to perforation or strangulation. All underwent simple closure of the hernia defect with interrupted or purse-string sutures. Ten patients recovered uneventfully, whereas one had wound seroma and ileus. Recurrence has not been observed in the 8 surviving patients. Obturator hernia should be included in the differential diagnosis of intestinal obstruction of unknown origin, especially in emaciated elderly women with chronic disease. Early surgical intervention without delay is imperative to avoid postoperative morbidity and mortality associated with intestinal strangulation due to obturator hernia. Obturator hernia can be sufficiently repaired with simple suture closure without mesh.

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Obturator hernias: a systematic review of the literature

Schizas

Αποστόλου

Hasemaki

et al. 2020

Hernia

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Case report: Laparoscopic totally extraperitoneal repair of an obturator hernia with self-gripping mesh under spinal anaesthesia

Abstract: Highlights Laparoscopic repair of obturator hernia with self-gripping mesh can adopted to reduce the morbidity of open repairs. It is safe to perform laparoscopic TEP repairs under spinal anesthesia.

Cited by 5 publications

References 15 publications

Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty

Small Bowel Obstruction Due to Incarcerated Obturator Hernia: Successfull Surgical Management with Modified Mesh-Plug Hernioplasty

Obturator hernia

Obturator hernias: a systematic review of the literature

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