Rare Case Of Bilateral Incarcerated Obturator Hernia: A Case Report

Hatipoğlu, Engin; Dal, Fatih; Umman, Veysel; Demiryas, Süleyman; Demirkıran, Oktay; Ertem, Metin; Ergüney, Sabri; Pekmezci, Salih

doi:10.5505/tjtes.2018.36559

Cited by 7 publications

(8 citation statements)

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“…An obturator hernia should be considered bilateral disease[ 78 ]. Hence, unilateral repair may not be sufficient[ 79 , 80 ]. The normal diameter of the obturator foramen is approximately 1.0 cm[ 81 ].…”

Section: Obturator Herniasmentioning

confidence: 99%

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

Yasukawa

Aisu

Hori

2020

WJGS

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Groin hernias include indirect inguinal, direct inguinal, and femoral hernias. Obturator and supravesical hernias appear very close to the groin. High-quality repairs are required for groin hernias. The concept of “tension-free repair” is generally accepted, and surgical repairs with mesh are categorized as “hernioplasties”. Surgeons should have good knowledge of the relevant anatomy. Physicians generally focus on the preperitoneal space, myopectineal orifice, topographic nerves, and regional vessels. Currently, laparoscopic surgery has therapeutic potential in the surgical setting for hernioplasty, with laparoscopic transabdominal preperitoneal (TAPP) repair appearing to be a powerful tool for use in adult hernia patients. TAPP offers the advantages of accurate diagnoses, repair of bilateral and recurrent hernias, less postoperative pain, early recovery allowing work and activities, tension-free repair of the preperitoneal (posterior) space, ability to cover obturator hernias, and avoidance of potential injury to the spermatic cord. The disadvantages of TAPP are the need for general anesthesia, adhering to a learning curve, higher cost, unexpected complications related to abdominal organs, adhesion to the mesh, unexpected injuries to vessels, prolonged operative time, and as-yet-unknown long-term outcomes. Both technical skill and anatomical familiarity are important for safe, reliable surgery. With increasing awareness of the importance of anatomy during TAPP repair, we address the skills and pitfalls during laparoscopic TAPP repair in adult patients using illustrations and schemas. We also address debatable points on this subject.

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Section: Obturator Herniasmentioning

confidence: 99%

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

Yasukawa

Aisu

Hori

2020

WJGS

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“…Laparoscopic surgery has been reported in several cases and is suitable for most patients except for those with peritonitis and bowel ischemia. 4,5 Here, we repaired the hernia using a surgical technique combining laparoscopy and preperitoneal space approach via a small lower abdominal median incision. The characteristic feature of this surgical technique is that the wound area of laparoscopy and that of mesh insertion are separate.…”

Section: Discussionmentioning

confidence: 99%

“…Obturator treatment by laparoscopic approach has recently reported, but that approach cannot be preferred in cases with ischemia/necrosis or bowel dilatation as ileus. 4,5 In some cases, clinically occult bilateral obturator hernias are detected during surgery. 6 Here, we report a case where a surgical technique combining laparoscopy and preperitoneal space approach via a small lower abdominal median incision was effective for treating obstructed and bilateral obturator hernias with bowel dilatation, which were unexpectedly detected during surgery.…”

mentioning

confidence: 99%

Effective Treatment for Incarcerated Obturator Hernia With Bowel Dilatation by Combined Laparoscopy and Preperitoneal Approach: A Case Report

Yaegashi

Tono²,

Minagawa³

et al. 2019

International Surgery

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We report a case of a 90-year-old female with intestinal obstruction due to left-sided incarcerated obturator hernia, which was revealed using computed tomography. Emergency surgery was performed using laparoscopy, which showed a dilated small intestine and bilateral obturator hernia in the intraperitoneal space. After reducing incarceration of the small intestine using laparoscopy, we approached the bilateral preperitoneal space and inserted a Kugel patch via a small lower abdominal median incision (approximately 4 cm). The patient was discharged on postoperative day 10 and showed no recurrence at the 18-month follow-up. Although relatively rare, obturator hernia can significantly cause intestinal obstruction. It has no specific clinical symptoms and is thus often difficult to diagnose. Treating obturator hernia is essential; however, mesh infection, recurrence, and opposite side of the obturator hernia should be carefully monitored. Although laparoscopy is used for treating obturator hernia, it may be difficult in patients with intestinal obstruction. In this case, a surgical technique combining laparoscopy and preperitoneal space approach via a small lower abdominal median incision was used to effectively treat an incarcerated occult bilateral obturator hernias.

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“…Obturator hernia should be considered a bilateral disease[ 157 ]; thus, unilateral repair may be inadequate[ 158 , 159 ]. The normal diameter of the obturator foramen is approximately 1.0 cm[ 160 ].…”

Section: Obturator Herniamentioning

confidence: 99%

Fascinating history of groin hernias: Comprehensive recognition of anatomy, classic considerations for herniorrhaphy, and current controversies in hernioplasty

Hori¹,

Yasukawa²

2021

WJM

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Groin hernias include indirect inguinal, direct inguinal, femoral, obturator, and supravesical hernias. Here, we summarize historical turning points, anatomical recognition and surgical repairs. Groin hernias have a fascinating history in the fields of anatomy and surgery. The concept of tension-free repair is generally accepted among clinicians. Surgical repair with mesh is categorized as hernioplasty, while classic repair without mesh is considered herniorrhaphy. Although various surgical approaches have been developed, the surgical technique should be carefully chosen for each patient. Regarding as interesting history, crucial anatomy and important surgeries in the field of groin hernia, we here summarized them in detail, respectively. Points of debate are also reviewed; important points are shown using illustrations and schemas. We hope this systematic review is surgical guide for general surgeons including residents. Both a skillful technique and anatomical knowledge are indispensable for successful hernia surgery in the groin.

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Rare Case Of Bilateral Incarcerated Obturator Hernia: A Case Report

Cited by 7 publications

References 0 publications

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

Crucial anatomy and technical cues for laparoscopic transabdominal preperitoneal repair: Advanced manipulation for groin hernias in adults

Effective Treatment for Incarcerated Obturator Hernia With Bowel Dilatation by Combined Laparoscopy and Preperitoneal Approach: A Case Report

Fascinating history of groin hernias: Comprehensive recognition of anatomy, classic considerations for herniorrhaphy, and current controversies in hernioplasty

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