Management of an obstructed recurrent inguinal hernia using a hybrid method: a case report

Abstract

Background For recurrent incarcerated and strangulated hernias, the optimal treatment strategy for each case is needed. Case presentation The study patient was a 70-year-old man. TAPP repair was performed for a left inguinal hernia (JHS Classification II-1) 7 years earlier. The patient experienced transient pain and swelling of the left inguinal region for 5 months and visited our emergency department for abdominal pain and vomiting. A CT scan showed a recurrent left inguinal hernia and small bowel incarceration, and emergency surgery was performed. Laparoscopic observation of the abdominal cavity revealed recurrent left inguinal hernia (Rec II-1) with small bowel incarceration. The small bowel was reduced after pneumoperitoneum, and no findings suggested intestinal tract necrosis. Adhesions around the herniated sac were dissected using an extraperitoneal approach and then shifted to mesh plug repair. No perioperative complications or hernia recurrence were observed in the 10 months after the surgery. Conclusions This report describes a novel, successful surgical treatment for a recurrent incarcerated hernia. In our patient, we could easily perform dissection and understand the positional relationship by hybrid surgery using the TEP method. Additionally, in patients with incarcerated hernias, we believe that performing hybrid surgery by combining the TEP method would be useful because bowel dilation caused by intestinal obstruction would not disturb the operative field.

An observational study of clinical presentation and emergency surgical management of obstructed inguinal hernia repair

“…32 For recurrent incarcerated and strangulated hernias, the optimal treatment should be selected for each case, such as the details of previous surgery, skill level of the practitioner, and general condition of the patient. 33 Present study found that the 'clearance of the toxic fluid and reduction of content and posterior wall repair' was the most common procedure performed to treat the obstructed hernia followed by 'hernia contents replacement in abdomen with meshplasty'. These findings were comparable with the study done by Padmsree et al Eze et al 16,34 A study done by Dai et al observed that 15.6% cases were treated by resection of necrotic bowel and anastomosis and 67.2% were treated by open tension-free herniorrhaphy with polypropylene mesh, 32.8% treated by herniorrhaphy without mesh.…”

Incarcerated multiple recurrent inguinal hernia with incidental finding of textiloma in the abdominal wall from previous hernia repair

“…Campanelli proposes the preperitoneal Stoppa operation, Wantz technique for unilateral inguinal recurrence or the laparoscopic approach [8] . Because of the lack of standard treatment for incarcerated recurrent inguinal hernia repair, there is various heterogeneity of the reported cases [ [11] , [12] – 13 ]. One should have in mind that the choice of treatment for incarcerated inguinal hernia should be fit to the patient- and hernia-related factors, the surgical skills, the available type of mesh and surgical equipment [14] .…”

Indications and Outcomes of a Hybrid Method Combining Laparoscopic and Anterior Approaches for Inguinal Hernia Repair

“…Therefore, we have proposed a hybrid method combining the laparoscopic and anterior approaches (hLAA) to repair complex IH, including recurrent IH and IH after RP. To date, only a few case reports have reported the short-term results after hLAA [ 13 , 14 , 19 ], and evaluation of the long-term efficacy of surgery for complex IH is essential. This study aimed to review the indications and long-term outcomes of hLAA, including hernia recurrence.…”