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Transabdominal Preperitoneal Repair for Obturator Hernia

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Abstract

Background

A laparoscopic surgical approach for obturator hernia (OH) repair is uncommon. The aim of the present study was to assess the effectiveness of laparoscopic transabdominal preperitoneal (TAPP) repair for OH.

Methods

From 2001 to May 2010, 659 patients with inguinal hernia underwent TAPP repair at in our institutes. Among these, the eight patients with OH were the subjects of this study.

Results

Three of the eight patients were diagnosed as having occult OH, and the other five were diagnosed preoperatively, by ultrasonography and/or computed tomography, as having strangulated OH. Bilateral OH was found in five patients (63%), and combined groin hernias, either unilaterally or bilaterally, were observed in seven patients (88%), all of whom had femoral hernia. Of the five patients with bowel obstruction at presentation, four were determined not to require resection after assessment of the intestinal viability by laparoscopy. There was one case of conversion to a two-stage hernia repair performed to avoid mesh contamination: addition of mini-laparotomy, followed by extraction of the gangrenous intestine for resection and anastomosis with simple peritoneal closure of the hernia defect in the first stage, and a Kugel hernia repair in the second stage. There was no incidence of postoperative morbidity, mortality, or recurrence.

Conclusions

Because TAPP allows assessment of not only the entire groin area bilaterally but also simultaneous assessment of the viability of the incarcerated intestine with a minimum abdominal wall defect, we believe that it is an adequate approach to the treatment of both occult and acutely incarcerated OH. Two-stage hernia repair is technically feasible in patients requiring resection of the incarcerated intestine.

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References

  1. Bjork KJ, Mucha P Jr, Cahill DR (1988) Obturator hernia. Surg Gynecol Obstet 167:217–222

    PubMed  CAS  Google Scholar 

  2. Yokoyama T, Munakata Y, Ogiwara M et al (1997) Preoperative diagnosis of strangulated obturator hernia using ultrasonography. Am J Surg 174:76–78

    Article  PubMed  CAS  Google Scholar 

  3. Ziegler DW, Rhoads JE Jr (1995) Obturator hernia needs a laparotomy, not a diagnosis. Am J Surg 170:67–68

    Article  PubMed  CAS  Google Scholar 

  4. Lo CY, Lorentz TG, Lau PW (1994) Obturator hernia presenting as small bowel obstruction. Am J Surg 167:396–398

    Article  PubMed  CAS  Google Scholar 

  5. Cubillo E (1983) Obturator hernia diagnosed by computed tomography. AJR Am J Roentgenol 140:735–736

    PubMed  CAS  Google Scholar 

  6. Gray SW, Skandalakis JE, Soria RE et al (1974) Strangulated obturator hernia. Surgery 75:20–27

    PubMed  CAS  Google Scholar 

  7. Neumayer L, Giobbie-Hurder A, Jonasson O et al (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827

    Article  PubMed  CAS  Google Scholar 

  8. McCormack K, Scott NW, Go PM et al (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785

  9. Mahon D, Decadt B, Rhodes M (2003) Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs. open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc 17:1386–1390

    Article  PubMed  CAS  Google Scholar 

  10. Cueto-Garcia J, Rodriguez-Diaz M, Elizalde-Di Martino A et al (1998) Incarcerated obturator hernia successfully treated by laparoscopy. Surg Laparosc Endosc 8:71–73

    Article  PubMed  CAS  Google Scholar 

  11. Wu JM, Lin HF, Chen KH et al (2006) Laparoscopic preperitoneal mesh repair of incarcerated obturator hernia and contralateral direct inguinal hernia. J Laparoendosc Adv Surg Tech A 16:616–619

    Article  PubMed  Google Scholar 

  12. Bryant TL, Umstot RK Jr (1996) Laparoscopic repair of an incarcerated obturator hernia. Surg Endosc 10:437–438

    Article  PubMed  CAS  Google Scholar 

  13. Kim JJ, Jung H, Oh SJ et al (2005) Laparoscopic transabdominal preperitoneal hernioplasty of bilateral obturator hernia. Surg Laparosc Endosc Percutan Tech 15:106–109

    Article  PubMed  CAS  Google Scholar 

  14. Tucker JG, Wilson RA, Ramshaw BJ et al (1995) Laparoscopic herniorrhaphy: technical concerns in prevention of complications and early recurrence. Am Surg 61:36–39

    PubMed  CAS  Google Scholar 

  15. Kugel RD (1999) Minimally invasive, nonlaparoscopic, preperitoneal, and sutureless, inguinal herniorrhaphy. Am J Surg 178:298–302

    Article  PubMed  CAS  Google Scholar 

  16. Novitsky YW, Czerniach DR, Kercher KW et al (2007) Advantages of laparoscopic transabdominal preperitoneal herniorrhaphy in the evaluation and management of inguinal hernias. Am J Surg 193:466–470

    Article  PubMed  Google Scholar 

  17. Rogers FA (1960) Strangulated obturator hernia. Surgery 48:394–403

    PubMed  CAS  Google Scholar 

  18. Crawford DL, Hiatt JR, Phillips EH (1998) Laparoscopy identifies unexpected groin hernias. Am Surg 64:976–978

    PubMed  CAS  Google Scholar 

  19. Evans DS, Ghaneh P, Khan IM (1996) Day-case laparoscopic hernia repair. Br J Surg 83:1361–1363

    Article  PubMed  CAS  Google Scholar 

  20. Panton ON, Panton RJ (1994) Laparoscopic hernia repair. Am J Surg 167:535–537

    Article  PubMed  CAS  Google Scholar 

  21. Thumbe VK, Evans DS (2001) To repair or not to repair incidental defects found on laparoscopic repair of groin hernia: early results of a randomized control trial. Surg Endosc 15:47–49

    Article  PubMed  CAS  Google Scholar 

  22. Losanoff JE, Richman BW, Jones JW (2002) Obturator hernia. J Am Coll Surg 194:657–663

    Article  PubMed  Google Scholar 

  23. Lavonius MI, Ovaska J (2000) Laparoscopy in the evaluation of the incarcerated mass in groin hernia. Surg Endosc 14:488–489

    Article  PubMed  CAS  Google Scholar 

  24. Hoffman A, Leshem E, Zmora O et al (2010) The combined laparoscopic approach for the treatment of incarcerated inguinal hernia. Surg Endosc 24:1815–1818

    Article  PubMed  Google Scholar 

  25. Legnani GL, Rasini M, Pastori S et al (2008) Laparoscopic trans-peritoneal hernioplasty (TAPP) for the acute management of strangulated inguino–crural hernias: a report of nine cases. Hernia 12:185–188

    Article  PubMed  CAS  Google Scholar 

  26. Leibl BJ, Schmedt CG, Kraft K et al (2001) Laparoscopic transperitoneal hernia repair of incarcerated hernias: is it feasible? Results of a prospective study. Surg Endosc 15:1179–1183

    PubMed  CAS  Google Scholar 

  27. Ishihara T, Kubota K, Eda N et al (1996) Laparoscopic approach to incarcerated inguinal hernia. Surg Endosc 10:1111–1113

    Article  PubMed  CAS  Google Scholar 

  28. Rebuffat C, Galli A, Scalambra MS et al (2006) Laparoscopic repair of strangulated hernias. Surg Endosc 20:131–134

    Article  PubMed  CAS  Google Scholar 

  29. Felix EL, Michas CA, Gonzalez MH Jr (1995) Laparoscopic hernioplasty. TAPP vs. TEP. Surg Endosc 9:984–989

    PubMed  CAS  Google Scholar 

  30. Tamme C, Scheidbach H, Hampe C et al (2003) Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc 17:190–195

    Article  PubMed  CAS  Google Scholar 

  31. Renzulli P, Frei E, Schafer M et al (1997) Preoperative Nyhus classification of inguinal hernias and type-related individual hernia repair. A case for diagnostic laparoscopy. Surg Laparosc Endosc 7:373–377

    Article  PubMed  CAS  Google Scholar 

  32. Larrieu AJ, DeMarco SJ 3rd (1976) Obturator hernia: report of a case and brief review of its status. Am Surg 42:273–277

    PubMed  CAS  Google Scholar 

  33. Fakim A, Walker MA, Byrne DJ et al (1991) Recurrent strangulated obturator hernia. Ann Chir Gynaecol 80:317–320

    PubMed  CAS  Google Scholar 

  34. Rimmer JA, Wharton S, Smedley FH et al (1990) Bilateral and recurrent obturator hernia. Br J Clin Pract 44:784

    PubMed  CAS  Google Scholar 

  35. Tchupetlowsky S, Losanoff J, Kjossev K (1995) Bilateral obturator hernia: a new technique and a new prosthetic material for repair—case report and review of the literature. Surgery 117:109–112

    Article  PubMed  CAS  Google Scholar 

  36. Bergstein JM, Condon RE (1996) Obturator hernia: current diagnosis and treatment. Surgery 119:133–136

    Article  PubMed  CAS  Google Scholar 

  37. Losanoff JE, Richman BW, Jones JW (2004) Sutureless plug repair of obturator hernia using a thigh approach. Ann R Coll Surg Engl 86:384

    PubMed  Google Scholar 

  38. Kozlowski JM, Beal JM (1977) Obturator hernia: an elusive diagnosis. Arch Surg 112:1001–1002

    PubMed  CAS  Google Scholar 

  39. Ijiri R, Kanamaru H, Yokoyama H et al (1996) Obturator hernia: the usefulness of computed tomography in diagnosis. Surgery 119:137–140

    Article  PubMed  CAS  Google Scholar 

  40. Nishina M, Fujii C, Ogino R et al (2001) Preoperative diagnosis of obturator hernia by computed tomography in six patients. J Emerg Med 20:277–280

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

Authors Takahide Yokoyama, Akira Kobayashi, Toshiki Kikuchi, Ken Hayashi, and Shinichi Miyagawa have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Takahide Yokoyama, Akira Kobayashi & Shinichi Miyagawa

  2. Department of Surgery, Showa-inan General Hospital, Komagane, Japan

    Takahide Yokoyama, Toshiki Kikuchi & Ken Hayashi

Authors
  1. Takahide Yokoyama
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  2. Akira Kobayashi
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  3. Toshiki Kikuchi
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  4. Ken Hayashi
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  5. Shinichi Miyagawa
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Correspondence to Akira Kobayashi.

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Yokoyama, T., Kobayashi, A., Kikuchi, T. et al. Transabdominal Preperitoneal Repair for Obturator Hernia. World J Surg 35, 2323–2327 (2011). https://doi.org/10.1007/s00268-011-1211-7

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  • DOI: https://doi.org/10.1007/s00268-011-1211-7

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