Transabdominal preperitoneal approach for incarcerated femoral hernia – a video vignette

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Abstract

The surgical approach to an acutely incarcerated femoral hernia differs from institution to institution. Recently, a laparoscopic transabdominal preperitoneal (TAPP) approach has been reported as feasible in this clinical situation [1-5.
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\nWe report the case of a 60‐year‐old woman who had undergone open left inguinal herniorrhaphy before presenting as an emergency 20 years later with hypogastric pain, abdominal distension, nausea and vomiting. The diagnosis of incarcerated right/left femoral hernia was simple and did not require a CT scan.
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\nWe performed a laparoscopy (Video S1) to evaluate the viability of the small and large bowel. After reducing the hernial contents, we performed a standard TAPP repair using polypropylene mesh.
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\nThis surgical approach allowed rapid visualization of the incarcerated loop and evaluation of its viability. The next step – repairing the hernia – is more of a challenge and requires appropriate training.
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\nIn conclusion, TAPP can be a safe and feasible surgical procedure in the emergency situation but the surgeon needs to have had the appropriate training.

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