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Laparotomy with suture repair is the most common treatment for obturator hernia: a scoping review

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Abstract

Background

Obturator hernias are rare and associated with high mortality. However, the optimal surgical approach remains unknown. We aimed to investigate the available evidence and examine the surgical details regarding obturator hernia defect closure as well as the recurrence rates of the different approaches.

Methods

We reported this scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews) and registered the protocol online. A comprehensive literature search in five different databases was conducted. The population was patients undergoing surgery for obturator hernia. Articles were included for data charting if the management of the hernia defect was reported. Data regarding surgical details, and hernia recurrence were extracted.

Results

A total of 1299 patients from 313 articles were included. In total, 937 patients underwent open obturator hernia repair, in which 992 hernias were repaired (including some bilateral obturator hernias). A total of 295 patients underwent laparoscopic repair for 341 obturator hernias, and for the remaining 67 patients, type of surgery was not reported. For open surgery, suture repair was the most common method of repair (n = 508, 51%) with a recurrence rate of 10%. For laparoscopic surgery, the most common repair of the defect was mesh repair (n = 299, 88%) with no reported recurrences.

Conclusion

Open surgery with primary suture repair is the most common method of repair for obturator hernia but is associated with a recurrence rate of 10%. Laparoscopic mesh repair is becoming more common and have seemingly very low recurrence rates and may be a better method of repair.

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Data availability

Data extraction sheet available upon request.

Code availability

Not applicable.

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Authors and Affiliations

  1. Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark

    Mikkel Andreas Holm, Siv Fonnes, Kristoffer Andresen & Jacob Rosenberg

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  1. Mikkel Andreas Holm
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  2. Siv Fonnes
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  3. Kristoffer Andresen
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  4. Jacob Rosenberg
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Contributions

Study conception and design: MH, SF, KA, and JR

Acquisition of data: MH and SF

Analysis and interpretation of data: MH and SF

Drafting of manuscript: MH

Critical revision of manuscript: MH, SF, KA, and JR

Corresponding author

Correspondence to Mikkel Andreas Holm.

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Holm, M.A., Fonnes, S., Andresen, K. et al. Laparotomy with suture repair is the most common treatment for obturator hernia: a scoping review. Langenbecks Arch Surg 406, 1733–1738 (2021). https://doi.org/10.1007/s00423-021-02293-8

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  • DOI: https://doi.org/10.1007/s00423-021-02293-8

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