Efficacy of emergency exploratory laparotomy in incarcerated obturator hernia

Abstract

The EEL is a clinically safe and necessary choice for early diagnosis and treatment in IOH. EEL may improve the curative effect of IOH significantly.

Which Patients Are a Better Candidate of Laparoscopic Repair in Obturator Hernia Patients?

“…But the superiority of laparoscopic surgery compared with the use of an open surgery was not been established yet, and laparoscopic surgery cannot apply to all cases due to the more challenging technology and longer learning curve. [11][12][13][14][15] In our study, we were able to confirm the feasibility of laparoscopic surgery and, at the same time, confirm that the use of laparoscopic surgery may be difficult depending on the degree of incarceration/strangulation. Even if the use of a laparoscopic surgery has the benefit of a good result as noted after the surgery, what is more important is to determine the fastest and safest surgical treatment for the patient.…”

The Feasibility and Potential Advantages of Laparoscopic Management of Incarcerated Obturator Hernia Over the Open Approach

“…Although the previous studies argued that laparoscopic surgery is a challenge for the patient with IOH mainly for 2 reasons: First, the abdominal space is limited, and highly dilated bowels are easy to injury during laparoscopic surgery. Second, laparoscopic management is a more challenging technology and needs a longer learning curve 16,17. However, the trend of operation is gradually from open to the laparoscopic approach, which has become an alternative treatment for IOH.…”

“…Second, laparoscopic management is a more challenging technology and needs a longer learning curve. 16,17 However, the trend of operation is gradually from open to the laparoscopic approach, which has become an alternative treatment for IOH. First, the laparoscopic approach has the feasibility and advantages of less trauma, fast recovery, less postoperative complication, less postoperative pain, and shorter hospital stay, while open abdominal surgery has great trauma and obvious postoperative pain, which increases the incidence of postoperative pulmonary infection, atelectasis and other complications in elderly patients.…”

“…Moreover, If IOH has severe symptoms of intestinal obstruction, obvious intestinal dilatation, narrow abdominal space, and difficulty in establishing pneumoperitoneum, open surgery showed greater superiority, which also had advantages of better exposure and convenience of bowel resection if necessary. 17 In addition, an open approach is also the only option for those elderly patients with severe cardiopulmonary diseases who cannot tolerate general anesthesia. In our study, 11 patients underwent open surgery through the lower middle incision in the open group, and 5 of them were performed with bowel resection.…”

“…Traditionally, open surgery is a safe and common choice for early treatment, usually with a lower middle incision, which can fully explore the abdominal cavity and find the necrotic bowel in time. Moreover, If IOH has severe symptoms of intestinal obstruction, obvious intestinal dilatation, narrow abdominal space, and difficulty in establishing pneumoperitoneum, open surgery showed greater superiority, which also had advantages of better exposure and convenience of bowel resection if necessary 17. In addition, an open approach is also the only option for those elderly patients with severe cardiopulmonary diseases who cannot tolerate general anesthesia.…”