If laparoscopic technique can be used for treatment of acutely incarcerated/strangulated inguinal hernia?

Abstract

Purpose Laparoscopic treatment for acutely incarcerated/strangulated inguinal hernias is uncommon and controversial. In the present study, we assessed the safety and feasibility of transabdominal preperitoneal (TAPP) repair for the treatment of acutely incarcerated/strangulated inguinal hernias. Methods Patients with acutely incarcerated/strangulated inguinal hernias who underwent TAPP repair at the Department of Hernia and Abdominal Wall Surgery (Beijing Chaoyang Hospital) from January 2017 to December 2019 were retrospectively reviewed. Patients’ characteristics, operation details, and postoperative complications were retrospectively analyzed. Results In total, 94 patients with acutely incarcerated/strangulated inguinal hernias underwent TAPP repair. The patients comprised 85 men and 9 women (mean age, 54.3 ± 13.6 years; mean operating time, 61.6 ± 17.7 min; mean hospital stay, 3.9 ± 2.2 days). No patients were converted to open surgery. Hernia reduction was successfully performed in all patients. The morbidity of complications was 20.2% (19/94). Two bowel resections were performed endoscopically. Nine (9.6%) patients avoided unnecessary bowel resections during laparoscopic procedures. All patients recovered well without severe complications. No recurrence or infection was recorded during a mean follow-up period of 26.8 ± 9.8 months. Conclusions TAPP appears to be safe and feasible for treatment of patients with acutely incarcerated/strangulated inguinal hernias. However, it requires performed by experienced surgeons in laparoscopic techniques.

Laparoscopic surgery for strangulated diaphragmatic hernia after radiofrequency ablation for hepatocellular carcinoma: a case report

“…The laparoscopic approach was reported to result in reduced morbidity in Bochdalek DH and might facilitate hernia reduction, haemostasis, and adhesiolysis [13]. Moreover, some reports described the feasibility of laparoscopy in similar conditions, such as in strangulated inguinal hernia and strangulated small bowel obstruction [14,15]. Minimally invasive surgery can be indicated for older adult patients with liver dysfunction and iatrogenic complications, such as in this case.…”

“…Pneumothorax is a potential complication of laparoscopic hernia defect repair, and other potential complications include bowel injury during the reduction and handling of the intruded intestine [13]. Blind, forceful traction is discouraged [14]. If irreversible ischaemic changes of the intruded intestine are extensive and the intestine is fragile, laparoscopic hernia reduction can be challenging and dangerous [15].…”

Fascia lata transabdominal pre-peritoneal repair in incarcerated inguinal hernia (FL TAPP) – A case report

“…Trans -abdominal pre-peritoneal has become an acceptable approach in the management of inguinal hernia in acute setting, either obstruction or incarceration [4] . It allows inspection of the contents during spontaneous reduction as often occurs following anesthesia, negating a formal laparotomy.…”

Emergency Groin Hernia Repair. Should We Always Search the Other Side?

“…The search string in free text search contained the following keywords: ("INGUINAL HERNIA" OR "GROIN HERNIA OR "FEMORAL HERNIA") AND "EMERGENCY". Surprisingly we found only four original articles who cite this condition and the evolution of these [4][5][6][7] . However, none of them had the contralateral hernia approach as a study objective, therefore lacking data from this specific population.…”

“…In 2013, the European Association for Endoscopic Surgery concluded that TAPP can be an option for treatment of incarcerated inguinal hernias 3 . Liu et al analized 94 patients who underwent TAPP for treatment of inguinal hernia in the emergency and found unrecognized contralateral hernia in 15 patients (15.9%) 4 . Mancini et al 5 reported an incidence of intraoperative diagnosis of contralateral hernia in 4 out 20 (20%) patients who underwent TAPP for hernia repair in the emergency.…”