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KMID : 1033020160060020033
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Journal of Hemiology: Diagnosis and Treatment of Hernias
2016 Volume.6 No. 2 p.33 ~ p.38
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Laparoscopic Herniorrhaphy for Treating Incarcerated Adult Inguinal Hernia
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Lee Sung-Ryul
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Abstract
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Purpose: Most patients with inguinal hernia present with a reducible inguinal bulge that requires elective surgery. However, in cases of incarcerated inguinal hernias (IIH), emergency surgery is necessary. We report the surgical outcomes of a laparoscopic transabdominal approach for IIH in adult patients.
Methods: Laparoscopic herniorrhaphy was performed on 76 adult patients with IIH from September 2012 to December 2016 at Damsoyu Hospital, Seoul, Korea. Surgical outcomes were retrospectively analyzed. An omentectomy with an additional scrotum incision was performed.
Results: All patients with IIH were males. The incarcerated organs were the bowel in 4 patients and the greater omentum in 72 patients. In 66 patients, organ preservation was performed by an intracorporeal reduction; however, in 10 patients, an omentectomy was performed because of reduction failure. An age less than 40 years, symptom duration over 1 year, indirect hernia, and high body mass index (BMI) were risk factors for an omentectomy in patients with IIH.
Conclusion: In most patients, intracorporeal reduction was achieved laparoscopically; but, inguinoscrotal hernias in young men whose symptoms lasted for a long period were difficult to reduce. After an omentectomy through a scrotal incision, laparoscopic herniorrhaphy could be performed without difficulty and was a useful method in patients with IIH.
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KEYWORD
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Incarceration, Laparoscopic herniorrhaphy, Irreducible hernia
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